array:25 [
  "pii" => "S0870255116303924"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2016.07.010"
  "estado" => "S300"
  "fechaPublicacion" => "2017-02-01"
  "aid" => "938"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "sco"
  "cita" => "Rev Port Cardiol. 2017;36:151-2"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2001
    "formatos" => array:3 [
      "EPUB" => 151
      "HTML" => 1472
      "PDF" => 378
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S217420491730034X"
      "issn" => "21742049"
      "doi" => "10.1016/j.repce.2017.02.010"
      "estado" => "S300"
      "fechaPublicacion" => "2017-02-01"
      "aid" => "938"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "sco"
      "cita" => "Rev Port Cardiol. 2017;36:151-2"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 1732
        "formatos" => array:3 [
          "EPUB" => 131
          "HTML" => 1235
          "PDF" => 366
        ]
      ]
      "en" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
        "titulo" => "Suprasternal echocardiography and aortic dissection"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "151"
            "paginaFinal" => "152"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Ecocardiografia supraesternal e disse&#231;&#227;o a&#243;rtica"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 2118
                "Ancho" => 2667
                "Tamanyo" => 545842
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Severe aortic regurgitation due to a prolapse of the cusps&#59; &#40;B&#41; suprasternal view&#44; at the level of the aortic arch&#44; showing an intimal flap &#40;blue arrow&#41; with supravalvar origin and extension to the aortic arch&#59; &#40;C and D&#41; cardiac computed tomography confirming the presence of a Stanford type A aortic dissection&#46; FL&#58; false lumen&#59; TL&#58; true lumen&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Liliana Reis, In&#234;s Almeida, Rog&#233;rio Teixeira, Andreia Fernandes, Jos&#233; Nascimento, Lino Gon&#231;alves"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Liliana"
                "apellidos" => "Reis"
              ]
              1 => array:2 [
                "nombre" => "In&#234;s"
                "apellidos" => "Almeida"
              ]
              2 => array:2 [
                "nombre" => "Rog&#233;rio"
                "apellidos" => "Teixeira"
              ]
              3 => array:2 [
                "nombre" => "Andreia"
                "apellidos" => "Fernandes"
              ]
              4 => array:2 [
                "nombre" => "Jos&#233;"
                "apellidos" => "Nascimento"
              ]
              5 => array:2 [
                "nombre" => "Lino"
                "apellidos" => "Gon&#231;alves"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0870255116303924"
          "doi" => "10.1016/j.repc.2016.07.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116303924?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491730034X?idApp=UINPBA00004E"
      "url" => "/21742049/0000003600000002/v1_201702240018/S217420491730034X/v1_201702240018/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0870255116304279"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2016.12.004"
    "estado" => "S300"
    "fechaPublicacion" => "2017-02-01"
    "aid" => "940"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "prv"
    "cita" => "Rev Port Cardiol. 2017;36:153-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3450
      "formatos" => array:3 [
        "EPUB" => 183
        "HTML" => 2755
        "PDF" => 512
      ]
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Recomendado do M&#234;s</span>"
      "titulo" => "Coment&#225;rio a &#171;Insufici&#234;ncia card&#237;aca esquerda e hipertens&#227;o pulmonar&#187;"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "153"
          "paginaFinal" => "154"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Comment on &#8220;Left ventricular failure and pulmonary hypertension&#8221;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Maria da Gra&#231;a Castro"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Maria da Gra&#231;a"
              "apellidos" => "Castro"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2174204917300314"
        "doi" => "10.1016/j.repce.2017.02.007"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917300314?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116304279?idApp=UINPBA00004E"
    "url" => "/08702551/0000003600000002/v1_201702090011/S0870255116304279/v1_201702090011/pt/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S0870255116303936"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2016.03.011"
    "estado" => "S300"
    "fechaPublicacion" => "2017-02-01"
    "aid" => "939"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Cardiol. 2017;36:149-50"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2144
      "formatos" => array:3 [
        "EPUB" => 189
        "HTML" => 1576
        "PDF" => 379
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
      "titulo" => "Multiple fistulae of all three coronary arteries draining into the pulmonary artery and concomitant coronary anomaly"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "149"
          "paginaFinal" => "150"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "F&#237;stulas m&#250;ltiplas nas tr&#234;s art&#233;rias coron&#225;rias drenando para a art&#233;ria pulmonar com anomalia coron&#225;ria concomitante"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 847
              "Ancho" => 1700
              "Tamanyo" => 94547
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Right coronary angiography demonstrating an anomalous origin of the left circumflex artery and coronary fistula to the pulmonary artery&#59; &#40;B&#41; right coronary angiography demonstrating coronary fistula from the conus branch to the pulmonary artery&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Mehmet Burak &#214;zen, Tahir Durmaz, H&#252;seyin Ayhan, Mehmet Erdo&#287;an"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Mehmet Burak"
              "apellidos" => "&#214;zen"
            ]
            1 => array:2 [
              "nombre" => "Tahir"
              "apellidos" => "Durmaz"
            ]
            2 => array:2 [
              "nombre" => "H&#252;seyin"
              "apellidos" => "Ayhan"
            ]
            3 => array:2 [
              "nombre" => "Mehmet"
              "apellidos" => "Erdo&#287;an"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2174204917300338"
        "doi" => "10.1016/j.repce.2017.02.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917300338?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116303936?idApp=UINPBA00004E"
    "url" => "/08702551/0000003600000002/v1_201702090011/S0870255116303936/v1_201702090011/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
    "titulo" => "Suprasternal echocardiography and aortic dissection"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "151"
        "paginaFinal" => "152"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Liliana Reis, In&#234;s Almeida, Rog&#233;rio Teixeira, Andreia Fernandes, Jos&#233; Nascimento, Lino Gon&#231;alves"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "Liliana"
            "apellidos" => "Reis"
            "email" => array:1 [
              0 => "liliana&#46;teles&#64;hotmail&#46;com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "In&#234;s"
            "apellidos" => "Almeida"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Rog&#233;rio"
            "apellidos" => "Teixeira"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Andreia"
            "apellidos" => "Fernandes"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Jos&#233;"
            "apellidos" => "Nascimento"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Lino"
            "apellidos" => "Gon&#231;alves"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Centro Hospitalar e Universit&#225;rio de Coimbra &#8211; Hospital Geral&#44; Coimbra&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Faculdade de Medicina da Universidade de Coimbra&#44; Coimbra&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Ecocardiografia supraesternal e disse&#231;&#227;o a&#243;rtica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1853
            "Ancho" => 2333
            "Tamanyo" => 420148
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Severe aortic regurgitation due to a prolapse of the cusps&#59; &#40;B&#41; suprasternal view&#44; at the level of the aortic arch&#44; showing an intimal flap &#40;blue arrow&#41; with supravalvar origin and extension to the aortic arch&#59; &#40;C and D&#41; cardiac computed tomography confirming the presence of a Stanford type A aortic dissection&#46; FL&#58; false lumen&#59; TL&#58; true lumen&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 48-year-old woman with no significant cardiovascular history presented to the hospital with a chief complaint of acute chest pain&#44; without radiation&#44; associated with an episode of blurred vision&#46; The physical examination was remarkable for a systolic blood pressure differential in the upper limbs &#40;left 129&#47;43 mmHg&#44; right 40&#47;20 mmHg&#41;&#44; absence of right radial and brachial pulses&#44; and a holodiastolic aortic murmur&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The electrocardiogram revealed left ventricular hypertrophy&#46; Emergent transthoracic echocardiography in left parasternal view showed dilatation of the thoracic ascending aorta &#40;43 mm&#41; and a bicuspid aortic valve&#44; with severe regurgitation due to prolapse of the cusps &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A&#41;&#46; In the suprasternal window&#44; at the level of the aortic arch&#44; an intimal flap with supravalvar origin and extension to the aortic arch&#44; descending thoracic and abdominal aorta was clearly evident &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B&#44; Videos 1 and 2&#41;&#46; Biventricular systolic function was normal and there was no pericardial effusion&#46; Subsequently&#44; cardiac computed tomography confirmed the presence of a Stanford type A aortic dissection &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C and D&#41;&#46; The patient was referred for emergent cardiac surgery&#46; At three months of follow-up&#44; she was asymptomatic&#44; with no signs of target organ damage&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Aortic dissection is an uncommon but potentially fatal condition&#46; The accessibility and diagnostic ability of bedside echocardiography enabled the rapid detection and prompt treatment of this condition&#44; contributing to the good end result&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:3 [
          "identificador" => "sec0005"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0010"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conflicts of interest"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-03-09"
    "fechaAceptado" => "2016-07-28"
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0115" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary material"
            "identificador" => "sec0060"
          ]
        ]
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1853
            "Ancho" => 2333
            "Tamanyo" => 420148
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Severe aortic regurgitation due to a prolapse of the cusps&#59; &#40;B&#41; suprasternal view&#44; at the level of the aortic arch&#44; showing an intimal flap &#40;blue arrow&#41; with supravalvar origin and extension to the aortic arch&#59; &#40;C and D&#41; cardiac computed tomography confirming the presence of a Stanford type A aortic dissection&#46; FL&#58; false lumen&#59; TL&#58; true lumen&#46;</p>"
        ]
      ]
      1 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:3 [
          "fichero" => "mmc1.mp4"
          "ficheroTamanyo" => 721824
          "Video" => array:2 [
            "mp4" => array:2 [
              "fichero" => "mmc1.m4v"
              "poster" => "mmc1.jpg"
            ]
            "flv" => array:5 [
              "fichero" => "mmc1.flv"
              "poster" => "mmc1.jpg"
              "tiempo" => 0
              "alto" => 0
              "ancho" => 0
            ]
          ]
        ]
      ]
      2 => array:5 [
        "identificador" => "upi0010"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:3 [
          "fichero" => "mmc2.mp4"
          "ficheroTamanyo" => 610971
          "Video" => array:2 [
            "mp4" => array:2 [
              "fichero" => "mmc2.m4v"
              "poster" => "mmc2.jpg"
            ]
            "flv" => array:5 [
              "fichero" => "mmc2.flv"
              "poster" => "mmc2.jpg"
              "tiempo" => 0
              "alto" => 0
              "ancho" => 0
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000003600000002/v1_201702090011/S0870255116303924/v1_201702090011/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "29264"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Imagens em Cardiologia"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003600000002/v1_201702090011/S0870255116303924/v1_201702090011/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116303924?idApp=UINPBA00004E"
]
Partilhar
Informação da revista
Vol. 36. Núm. 2.
Páginas 151-152 (fevereiro 2017)
Partilhar
Partilhar
Baixar PDF
Mais opções do artigo
Vol. 36. Núm. 2.
Páginas 151-152 (fevereiro 2017)
Image in Cardiology
Open Access
Suprasternal echocardiography and aortic dissection
Ecocardiografia supraesternal e disseção aórtica
Visitas
5601
Liliana Reisa,b,
Autor para correspondência
liliana.teles@hotmail.com

Corresponding author.
, Inês Almeidaa,b, Rogério Teixeiraa,b, Andreia Fernandesa,b, José Nascimentoa,b, Lino Gonçalvesa,b
a Centro Hospitalar e Universitário de Coimbra – Hospital Geral, Coimbra, Portugal
b Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
Este item recebeu

Under a Creative Commons license
Informação do artigo
Texto Completo
Baixar PDF
Estatísticas
Figuras (1)
Material adicional (2)
Texto Completo

A 48-year-old woman with no significant cardiovascular history presented to the hospital with a chief complaint of acute chest pain, without radiation, associated with an episode of blurred vision. The physical examination was remarkable for a systolic blood pressure differential in the upper limbs (left 129/43 mmHg, right 40/20 mmHg), absence of right radial and brachial pulses, and a holodiastolic aortic murmur.

The electrocardiogram revealed left ventricular hypertrophy. Emergent transthoracic echocardiography in left parasternal view showed dilatation of the thoracic ascending aorta (43 mm) and a bicuspid aortic valve, with severe regurgitation due to prolapse of the cusps (Figure 1A). In the suprasternal window, at the level of the aortic arch, an intimal flap with supravalvar origin and extension to the aortic arch, descending thoracic and abdominal aorta was clearly evident (Figure 1B, Videos 1 and 2). Biventricular systolic function was normal and there was no pericardial effusion. Subsequently, cardiac computed tomography confirmed the presence of a Stanford type A aortic dissection (Figure 1C and D). The patient was referred for emergent cardiac surgery. At three months of follow-up, she was asymptomatic, with no signs of target organ damage.

Figure 1.

(A) Severe aortic regurgitation due to a prolapse of the cusps; (B) suprasternal view, at the level of the aortic arch, showing an intimal flap (blue arrow) with supravalvar origin and extension to the aortic arch; (C and D) cardiac computed tomography confirming the presence of a Stanford type A aortic dissection. FL: false lumen; TL: true lumen.

(0.4MB).

Aortic dissection is an uncommon but potentially fatal condition. The accessibility and diagnostic ability of bedside echocardiography enabled the rapid detection and prompt treatment of this condition, contributing to the good end result.

Ethical disclosuresProtection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data

The authors declare that they have followed the protocols of their work center on the publication of patient data.

Right to privacy and informed consent

The authors declare that no patient data appear in this article.

Conflicts of interest

The authors have no conflicts of interest to declare.

Copyright © 2016. Sociedade Portuguesa de Cardiologia
Baixar PDF
Idiomas
Revista Portuguesa de Cardiologia
Opções de artigo
Ferramentas
Material Suplementar
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.