RESUMO
Seventy patients with rheumatic mitral disease were studied by M-Mode and 2D echocardiography in order to detect left atrial thrombosis before surgery. Thrombosis were suspected by the observation of abnormal echoes in the left atrium. During surgery 17 (24%) patients had atrial thrombosis. It had been suspected by echocardiography in 12 (sensitivity 70%). In 53 patients thrombosis were not found during surgery; in 46 the echo had been also negative (specificity 86%). There was a false positive detection of thrombosis by echo in 7 patients (14%) and false negativity in 5 (30%). Patients with atrial thrombosis had atrial fibrilation in 91% of cases; and the most frequent valvular disease was mitral stenosis. There was not a direct relationship among existence of left atrial thrombosis and the anteroposterior diameter of the left atrium as measured by echo. We conclude that echocardiography has good specificity to rule out atrial thrombosis and moderate sensitivity to detect it in rheumatic mitral disease.
Assuntos
Ecocardiografia , Cardiopatias/diagnóstico , Trombose/diagnóstico , Adulto , Feminino , Átrios do Coração , Cardiopatias/etiologia , Doenças das Valvas Cardíacas/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral , Cardiopatia Reumática/complicações , Trombose/etiologiaRESUMO
Se estudiaron 70 pacientes con valvulopatia mitral reumatica con ecocardiografia modo M y bidimensional, para detectar trombos en la auricula izquierda, previamente a la cirugia. La trombosis se sospecho por la observacion de ecos anormales en el interior auricular. Durante la correccion quirurgica se encontraron trombos auriculares en 17 (24%). De ellos, la trombosis se sospecho por ecocardiografia en 12 (o sea, sensibilidad de 70%). No se encontraron trombos durante la cirugia en 53 pacientes; en 46 de ellos el eco tampoco la sugirio (especificidad 86%). El eco mostro falsa positividad en 7 pacientes (14%) y falsa negatividad en 5 (30%). En el 91% de los pacientes con trombosis auricular existia fibrilacion auricular y la lesion valvular mas frecuentemente encontrada fue la estenosis mitral. No se encontro relacion directa entre la existencia de trombosis auricular y el diametro anteroposterior de dicha cavidad medido por ecocardiografia. Por los resultados obtenidos podemos concluir que la ecocardiografia tiene buena especificidad para descartar trombosis auricular y moderada sensibilidad para detectarla en la valvulopatia mitral