The authors report on rapid tumor regression of a giant rhabdomyoma with Everolimus treatment documented by three-dimensional echocardiography.

A 42-year-old man presented with a viral prodrome and tested positive for influenza A. He rapidly deteriorated developing cardiogenic shock, rhabdomyolysis and acute kidney injury. Patient improved 1 week later with supportive measures including vasopressors, inotropes and an intraaortic balloon pump. We report this case as it highlights the discordance between echocardiographic ventricular wall thickening as a result of myocardial edema, and electrocardiographic findings at presentation, with a reversal in findings at time of resolution. Additionally there was some suggestion of a regional pattern to the reduced longitudinal strain.

Caseous calcification is usually an incidental finding on the atrioventricular valvular annulus. The exact mechanism of pathogenicity for the caseous calcifications has not been defined yet. Differential diagnosis includes vegetation, thrombus, or metastatic tumors. We presented a case of a large tricuspid mass as an incidental finding by transthoracic echocardiography in a patient with metastatic colon cancer. The distinction between caseous calcification and metastatic tumor was made based on the typical location of calcification, possible extension to the whole mitral annulus, well-defined borders, and the internal echolucent area.

The preservation of the subvalvular apparatus (SVA) during mitral valve replacement (MVR) surgery due to rheumatic valve disease remains controversial. The presence of intense fibrosis and calcification in rheumatic valves may promote impingement of the pannus tissue on the prosthesis and cause obstruction of the mitral inflow tract. Here we present an obstructive left ventricular side mitral pannus tissue image in a patient who had undergone rheumatic MVR with the preservation of SVA.

A 41-year-old man was admitted to our hospital because of shortness of breath. Two-dimensional transesophageal echocardiography revealed the presence of a horseshoe-shaped unicuspid aortic valve (UAV) with two raphes at 4 and 8 o'clock positions of the aortic leaflet, and prolapse of the noncoronary cusp. Three-dimensional transesophageal echocardiography (3DTEE) clearly showed UAV, and another raphe was observed at the 7 o'clock position of the aortic leaflet. The Bentall procedure was performed, and surgical inspection confirmed the diagnosis of UAV based on the quadricuspid aortic valve. The excised specimen of the aortic valve was remarkably similar to the findings of 3DTEE.

We present the case of an infant with coronary artery stenosis following an arterial switch operation for transposition of the great arteries. He was demonstrated to have reversible regional myocardial ischemia using speckle tracking echocardiography (STE), which corresponded to the affected territory seen when he underwent cardiac catheterization with revascularization. This demonstrates the utility of STE in infants with regional myocardial dysfunction.