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#20 De: E Londo <elondono@impsat.net.co
Enviado: Jue, 16 Mar 2000 20:23
Asunto: Participacion discucion/Participation in discussion
Sponsored by: Laboratorios Gador
Esta paciente con la historia anotada, presenta en el estudio ecocardiografico de estres una alteracion de contractilidad segmentaria de los tercios basal y medio de la pared anterior y el septum anterior, lo cual debe hacer sospechar una lasion de la
arteria coronaria descendente anterior proximal. Concidero que con estos hayazgos el paciente debe ser estudiado mediante arteriografia coronaria para confirmar la lesion, buscar otras lesiones en otros vasos y con toda la informacion definir cual seria la conducta a segir.
Mil gracias y felicitaciones

This patient with written history, presented in the stress echocardiographic study an alteration of segment contractility of the
basal and medium thirds of the anterior wall, and anterior septum, a fact that should makes us suspect a lesion on proximal anterior
descending coronary artery. I think that with these findings the patients must be studied through coronary arteriography to confirm
the lesion, to search for other lesions in other vessels, and with all the information define which would be the management to
follow.
Thank you very much, and congratulations,
E Londo

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#21 De: Guilherme Gustavo do Valle   <guilhermedovalle@uol.com.br>
Enviado: Sat, 18 Mar 2000 13:10
Asunto: Comentarios sobre caso apresentado pelo Dr. Jamil Valente/Commentaries on the case presented by Dr. Jamil Valente
Sponsored by: Pfizer
PORTUGUES:
Notamos evidente hipocinesia significativa da parede septal, poupando  apenas o terco inicial desta parede no eixo longo. No eixo curto
observamos que alem da parede septal, a parede anterior (neste corte visto o seu segmento medio), tambem encontra-se significativamente
acometido, o que sugere acometimento significativo da arteria descendente anterior em localizacoes proximais da mesma.
Gostaria de perguntar se o exame reproduziu em algum grau o sintoma de dor precordial, que o paciente apresentava na sua historia clinica.
Gostaria de aproveitar e parabeniza-los por este tipo de iniciativa na internet, o que julgo muito oportuno.

ENGLISH:
We see significant septal wall hypokinesia, sparing only the begining of the septum at long axis view. From the short axis view we can observe
also hypokinesia of the anterior wall (in this window we see only the medium segment) besides the septal disturbance, which suggest
significant lesion of the proximal descendent anterior coronary artery. I'd like to ask if the Stressecho was able to reproduce some degree of
chest pain, as the patient refered in his clinical history.
Congratulations for this kind of work using internet, which I think is very helpful.
Guilherme Gustavo do Valle, Brazil
http://www.geocities.com/guilhermedovalle
http://sites.uol.com.br/guilhermedovalle

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CETIFAC
Bioengineering
UNER

Update
Mar/22/2000