ABC | Volume 113, Nº3, September 2019

Case Report Cilsal Single-ventricle atrioventricular connection in elderly individual Arq Bras Cardiol. 2019; 113(3):438-443 In our case, typical stenotic changes and doming that seen in rheumatic diseases were not present in the tricuspid leaflet. Uniformly, mildly thickened tricuspid leaflets were present with a relatively fixed valve orifice without stenosis. Cardiac carcinoid usually affects the right cardiac chamber of the heart and results in a similar presentation. However, it is not reported in the pediatric age group in the literature. Nevertheless, carcinoid tumor should also be considered as a differential diagnosis in isolated advanced tricuspid valve involvement. 9 In our case in contrast to the carcinoid tumor, the tricuspid valve did not exhibit very bright echoes secondary to fibrous plaques that are deposited on the endocardium of the leaflets. 10 Biogenic amine levels in plasma and urine samples were found to be in the normal range that excluded diagnosis of carcinoid tumor. The related literature indicates similar findings in patients with thalassemia; however, illustration of echocardiograms in children is not satisfactory. Aessopos et al. 6 reported valvular involvement including leaflet thickening (48%), endocardial calcification (20%), and left-sided valve regurgitation in adult patients with thalassemia intermedia. 6 In our case, the patient had serious dysrhythmias due to endocardial involvement, contraction and relaxation Video 4 – Transthoracic echocardiography from the parasternal long axis view showing normal systolic function of the left ventricle and minimal pericardial effusion. To view the video click on the link: https://bit.ly/2lTc6iX Video 5 – Transthoracic echocardiography from the parastrenal short axis view showed enlargement of the right ventricle and pericardial effusion. To view the video click on the link: https://bit.ly/2lTc6iX 442