PMC3466877_01
Echocardiographic short-axis view, showing conal septum (arrow); it had been previously mistaken as vegetation
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Precise echocardiography showed that the mass was the conal septum and not tricuspid valve vegetation as had been previously diagnosed (Figure 1).
PMC3466877_02
Subcostal coronal view, showing aortic left ventricular tunnel (arrow). In the previous echocardiographic evaluation, it had been ignored
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However, when the patient was subsequently referred to our Pediatric Eechocardiography Laboratory for further assessment of the aortic valve anatomy, precise echocardiography revealed that the regurgitation originated from an aortic left ventricular tunnel, ruling out the aortic valve pathology (Figure 2).
PMC3466877_03
Subcostal sagittal view from the right atrium, showing the Chiari net (arrow). It had been previously mistaken as an abnormal mass
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Precise echocardiography revealed a large and crescent-shaped Thebesian valve, which is a normal variant and is called the Chiari net (Figure 3).
PMC3466877_04
Parasternal short-axis view from the main pulmonary artery and its bifurcation, showing an anterior extra cardiac tissue (arrow), which is the thymus gland. It is not abnormal during infancy
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Echocardiography showed an extra cardiac mass in the short-axis view, requiring in-depth echocardiographic evaluation in our pediatric echo lab, where precise echocardiography revealed that, far from being a real mass, the shadow was indeed the thymus gland (Figure 4).
PMC3466877_05
Suprasternal long-axis view, showing dilated brachiocephalic arteries (arrow). This finding had been missed in the previous echocardiographic examination
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These findings were highly suggestive of cranial arteriovenous fistula, and subsequent diagnostic procedures confirmed this diagnosis (Figure 5).