Endomyocardial Fibrosis (EMF) is a restrictive cardiomyopathy characterized by the fibrotic involvement of the endomyocardium. Describe an uncommon case and the general aspects of this entity. A 13-year-old female patient was admitted with a suspect of acute gastroenteritis. Cursed with intense protein depletion and deteriorating health conditions. During the investigation was diagnosed with Ulcerative Colitis. The Doppler echocardiogram showed hyperrefingent images and a tumoration-sugestive lesion in both ventricles. The cardiac magnetic resonance confirmed the presence of tumorations in the apical portion of right and left ventricles. The patient was submitted to a biventricular resection of the masses. After the intervention, clinical therapy was started. The diagnosis of EMF was later confirmed on the histopathologic examination. The clinical presentation of EMF is unspecific and difficult to recognize, demanding deep investigation skills. The correlation with imaging exams for diagnosis is essential, especially the echocardiogram and the magnetic resonance. In this case, it is observed the association between Ulcerative Colitis and EMF, as well as the potential of the imaging modalities in the confirmation and therapeutic guidance of this pathology.

Cardiac arrest is an event that provides an elevated mortality rate. When not fatal, it can lead to neurological and other systems impairment, which may affect the prognosis of the patient. To avoid cerebral damage related to the event, some methods are indicated including therapeutic hypothermia. However, it remains unknown yet how effective is this procedure to mitigate such risk. The purpose of this literature review consisted in the systematic review of current data in order to collect what is most relevant about hypothermia as a therapeutic modality in patients after cardiac arrest. Online databases like SCIELO, MEDLINE, LILACS and PUBMED were used for the development of this review. The choice of hypothermia as a therapeutic measure in the moment post-cardiac arrest has appeared as an effective choice, especially after the analysis of biological and biochemical markers and imaging exams, which are important neurologic outcomes predictors. The achievement of a lower temperature at a specific time has showed itself as an important aspect in the neurologic outcome improvement. Therefore, it contributes to the consolidation of the hypothermia as an effective approach post-cardiac arrest. Therefore, it is possible to determine that its use has been proven as beneficial.

Introduction: The disease caused by Coronavirus-2019 (COVID-19) was initially described in December 2019. Severe acute respiratory syndrome type 2 (Sars-Cov-2) is responsible for an important multisystem inflammatory spectrum. Cardiovascular conditions have been reported with an estimated frequency of 8-28%. In this context, transthoracic echocardiography associated with the analysis of the two-dimensional Global Longitudinal Strain (GLS) of the left ventricle derived from Speckle Tracking emerges as a promising modality. Objective: This study aims to evaluate the applicability of GLS and segmental deformity assessment in detecting subclinical myocardial dysfunction in patients that recovered from COVID-19 infection. Methods: The observational study involved 18 patients (mean age 52 years) with recent evidence of COVID-19 infection that underwent detailed echocardiographic evaluation with GLS, and cardiac magnetic resonance (CMR) according to segmental assessment results. The degree of correlation between the methods was analyzed and a systematic literature review was also conducted. Results: The mean left ventricular ejection fraction (LVEF) was 57.50 ± 9.98%. Only 16.6% of patients had reduced LVEF. The average GLS was – 18.70 ± 3.54% and in 44% of cases only one myocardial segment was affected, particularly the inferolateral basal. CMR revealed inflammatory cardiomyopathy. Discussion: Subclinical myocardial involvement is associated with major adverse cardiac events. Literature review supports the use of GLS for detecting early cardiac involvement. Conclusion: Speckle-tracking echocardiography has been shown to have clinical utility in a variety of settings and to offer superior prognostic value with a potential to enhance subclinical detection of myocardial changes in patients after COVID-19 infection.

Left ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital heart disease with an estimated incidence of 0.014-0.045% in a general population. It occurs due to a morphogenetic abnormality during embryogenesis that inhibits myocardial compaction and determines prominent trabeculae with deep intertrabecular spaces and thickening of the adjacent myocardium in two distinct layers. Diagnosis is generally established via transthoracic echocardiogram (TTE) with further confirmation with cardiac magnetic resonance (CMR). A 57-year-old male patient previously diagnosed with systemic arterial hypertension and chronic obstructive pulmonary disease reported chest pain and dyspnea upon exertion, headache, and dizziness. During outpatient investigation, the patient was submitted to a stress electrocardiogram that was positive for ischemia and led to a cineangiocoronariography with no signs of coronary artery obstruction. At the echocardiography lab, several trabeculations were detected in the apical region of the left ventricle. A diagnosis of LVNC was established and the results were confirmed via CMR. Management was initiated with the goal of symptom relief. LVNC is a relatively unknown pathology that is frequently underdiagnosed at earlier stages. As presented, we highlight the importance of multimodality imaging, especially TTE and CMR, in the diagnosis of this congenital heart condition.

Introduction: Left ventricular dysfunction as an independent predictor of mortality in Chagas disease. Global longitudinal strain (GLS) is an

Introduction: Long QT syndrome is a clinical condition that affects cardiac repolarization with an increased risk for the development of severe ventricular arrhythmias. The acquired form can be induced by drugs, such as selective serotonin reuptake inhibitors. Case report: E.A.C.G., female, 83 years-old, previously diagnosed with major depressive disorder in use of Fluoxetine the 80mg/day, was admitted in the emergency department after a syncopal event. An important widening of the QT interval was noted on the occasion, with a corrected value of 580ms. A 24-hour Holter monitoring showed increased ectopic ventricular activity (18% of beats), prolonged QT interval (up to 630 ms), and high-complexity ectopic ventricular beats. Non-sustained ventricular tachycardia was also observed (1030 episodes). The prolonged QT interval was associated to an elevated dose of Fluoxetine. Discussion: We believe that the coexistence between a high dose of Fluoxetine and other risk factor such as female sex and increased age contributed to the development of the case presentation. Conclusion: The rising prevalence of depression in the geriatric population and the indiscriminate use of antidepressive agents such as selective serotonin reuptake inhibitors may contribute to an increase in potentially severe cardiovascular complications.