Footnotes Editorials published in the Journal of Cardiovascular

Ultrasound do not necessarily represent the views of JCU or the Korean Society of Echocardiography.
A 70-year-old woman with a history of hypertension presented to our outpatient department complaining of recently developed exertional dyspnea. On physical examination, her blood pressure was 100/70 mmHg and the pulse rate was Inhibitors,research,lifescience,medical 105/min with an irregular rhythm. Auscultation of the lungs revealed bilateral crackles at both lower lung fields, and a faint systolic murmur was noted at the mitral valve area. The electrocardiography showed atrial fibrillation with a rate of 100 beats per minute. A transthoracic echocardiogram revealed diffusely hypokinetic left ventricular wall motion with an ejection fraction of 35-40% and mild aortic valve regurgitation. The left atrium was enlarged and its diameter was 42 mm. Transesophageal Inhibitors,research,lifescience,medical echocardiography was conducted to identify the presence of thrombus before performing electrical cardioversion. This study revealed marked spontaneous echo contrast in the left atrium without any visible thrombus. The LAA had a small tubular shape, and the orifice was narrow with

a diameter of 4.8 mm Inhibitors,research,lifescience,medical (Fig. 1A). Color turbulence across the orifice of the LAA with a peak velocity of more than 100 cm/sec was also noted (Fig. 1B and C). The direct current external find more cardioversion was performed without any complication and the patient was discharged with maintaining Inhibitors,research,lifescience,medical normal sinus rhythm. Fig. 1 Transesophageal echocardiography of the case 1 revealed a small tubular shaped left atrial appendage with a narrowed orifice, and the maximal diameter of the orifice was only 4.8 mm (A). Doppler examination showed significant flow acceleration across … Case 2 Inhibitors,research,lifescience,medical A 68-year-old

male presented with newly developed palpitation. He had a history of diabetes mellitus, hypertension and coronary artery disease along with a history of coronary artery bypass surgery 16 years ago. On physical examination, his blood pressure was 120/70 mmHg and the heart rate was approximately 140/min. Auscultation of the lung and heart was not remarkable. The electrocardiography showed atrial flutter with 2 Parvulin : 1 ventricular conduction. Pharmacological cardioversion was tried first, but this failed. A transthoracic echocardiogram revealed global left ventricular systolic dysfunction with an ejection fraction of 35% and a dilated left atrium. On the transesophageal echocardiography, neither intracardiac thrombus nor spontaneous echo contrast was seen. The diameter of the orifice of the LAA was 3.6 mm, and the body of the LAA showed a long tubular shape (Fig. 2A). The flow was accelerated at the ostium of the LAA with peak velocities of more than 110 cm/sec (Fig. 2B and C). Direct current external cardioversion was successfully performed, and the patient was discharged without any adverse events. Fig.