In a retrospective multicentre study, the diagnostic potential of transoesophageal 2D-echocardiography (TEE) as compared to precordial 2D-echocardiography (TTE) was determined in 154 patients with primary or secondary tumours of the heart. Additionally, the value of standard diagnostic parameters, such as symptoms, X-ray of the chest and electrocardiogram were evaluated. In 84 patients (24 male, 60 female; age 20-85, mean 56.6 years) intracardial tumours were present, and 70 patients (37 male, 33 female; age 18-79, mean 44.3 years) presented with peri- or paracardial tumours. The main symptoms of patients with intracardial tumours were dyspnoea (60.7%), vena cava syndrome (22.2%) and chest pain (20.2%). Embolization was found in 11.9%. Left or right atrial enlargement was observed on chest X-ray in 23 patients, and echocardiographic abnormalities in 17 cases. The patients with peri- or paracardial tumours presented with dyspnoea in 51.4% of cases, loss in body weight in 20.0% and with vena cava syndrome and chest pain in 17.1%. The chest X-ray was abnormal in 56 patients. Unspecific ST segment changes in the electrocardiogram were observed in five, and arrhythmias in seven cases. Diagnosis of atrial myxomas was achieved by TTE in 95.2%, by TEE in 100%, by angiography in 78.4%, by computed tomography (CT) or magnetic resonance tomography (NMR) in 70%. Identification of the attachment point was made by angiography in 8.1%, by TTE in 64.5% and by TEE in 95.2%. In 22 patients with intracardial tumours (myxomas excepted) diagnosis was achieved by TTE in 90.9%, by TEE in 100%, by CT or NMR in 88.9% and by angiography in 50%.(ABSTRACT TRUNCATED AT 250 WORDS)

In 22 patients without a previous history of cardiac disease, we prospectively evaluated cardiac involvement during acute malaria and 9 +/- 5 months after recovery using non-invasive methods including resting electrocardiogram (ECG) and two-dimensional (2D) echocardiography. During the acute phase ECG abnormalities were common (5/22); pericardial effusion was found in 2 patients and global left ventricular hypokinesia in 1 patient infected with Plasmodium falciparum. At a follow-up of 19 patients, the resting ECG and echocardiography were normal or had normalized in all patients. The results of our study suggest that persistent cardiac damage following malarial infection seems to be rare; however, further trials in a larger patient population are needed to confirm our findings.

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The aim of this study was to assess the diagnostic value of intraoperative 2-D color Doppler transesophageal echocardiography (ITEE) for the surgeon and anesthesiologist in patients undergoing coronary bypass surgery or heart valve replacement. Information given by ITEE in 100 cardiac operations was documented. We judged the ITEE information, considering to what extent it was not to be obtained by other methods and to what extent it influenced the operation itself. The value was classified as dispensable (0), informative (1), valuable (2), or essential (3). In 50 consecutive patients with heart-valve replacement (25 aortic valve prostheses, 25 mitral valve prostheses) ITEE was 38 x (0), 8 x (1), 4 x (2). In 50 consecutive patients undergoing coronary artery bypass graft surgery it was 33 x (0), 11 x (1), 4 x (2), 2 x (3). The two essential diagnoses referred to undetected vein graft occlusions. Information classified as valuable mainly referred to left and right ventricular function or valvular and prosthetic valve function when difficulties occurred during and after extracorporeal circulation. In conclusion, information given by ITEE, although generally regarded as dispensable in the procedures considered, was valuable in 10% of cases and in 2% even essential.

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