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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A and B&#41; Chest radiography during the episode of heart failure after treatment&#59; &#40;C&#41; L wave between rapid left ventricular &#40;LV&#41; filling &#40;E wave&#41; and atrial contraction &#40;A wave&#41;&#59; &#40;D&#41; no L wave after decongestion&#44; with impaired LV relaxation pattern &#40;E</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">L waves are an unusual finding in the analysis of mitral valve pulsed-wave Doppler&#46; This wave is recorded as flow between the left atrium and left ventricle during diastole&#44; due to elevated left ventricular &#40;LV&#41; filling pressures&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1&#8211;3</span></a> In this situation&#44; triphasic mitral filling can be observed&#44; with the presence of mid-diastolic L waves&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a 71-year-old female with preserved LV ejection fraction &#40;LVEF&#41; and moderate ventricular hypertrophy secondary to hypertensive cardiomyopathy&#44; according to a cardiac magnetic resonance study performed the year before&#46; The patient had an episode of acute pulmonary edema during an admission for malaria&#44; with complications of fever&#44; acute kidney disease and hypertensive crisis&#46; During the initial assessment&#44; a transthoracic echocardiogram was performed&#44; which showed high LV filling pressure &#40;E&#47;E&#8242; ratio 23&#41;&#44; systolic pulmonary pressure of 60 mmHg estimated by tricuspid regurgitation Doppler&#44; and L waves on mitral pulsed-wave Doppler &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; Laboratory tests showed NT-proBNP of 1962 pg&#47;ml&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">After treatment with antihypertensive drugs and diuretics&#44; following diuresis of 12 l in three days&#44; the patient had normal LV filling pressure &#40;E&#47;E&#8242; ratio 12&#41; and systolic pulmonary pressure of 32 mmHg&#44; and the L wave had disappeared on the echocardiogram&#44; which showed an impaired relaxation pattern in LV filling &#40;E<a class="elsevierStyleCrossRef" href="#sec0015">Videos 1 and 2</a>&#41;&#44; and a decrease in left atrial volume &#40;from 52&#46;1 to 31&#46;7 ml&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was discharged in good condition after recovery of renal function and adjustment of antihypertensive therapy&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In this paper&#44; we report the presence of L waves during an episode of acute pulmonary edema in a patient with preserved LVEF&#44; in the context of high LV filling pressure&#46; Recognizing this pattern of diastolic filling can be helpful in the rapid diagnosis and treatment of similar cases of heart failure&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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