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Background: We aimed to depict the electrocardiographic and echocardiographic aspects in patients before elective major vascular surgery. Methods: We evaluated through standard 12 lead electrocardiography and transthoracic echocardiography 469 patients with asymptomatic large abdominal aortic aneurysm (AAA), 334 with critical carotid stenosis (CAS), and 238 with advanced peripheral artery disease (PAD) before surgical revascularization. Results: Patients with AAA were predominantly males ( p  < .001) with normal sinus rhythm ( p  = .026), were more affected by atrioventricular block ( p  = .033) and left anterior fascicular block ( p  < .001). They also presented larger aortic root size ( p  < .001) and septal hypertrophy ( p  = .036), in addition, atrial fibrillation was less frequent in the same group ( p  = .023). Patients with CAS were of older age ( p  < .001) with a substantial number of females ( p  < .001). They presented less left ventricular segmental kinetic disorders and fewer dilated ventricles ( p  = .004 and p  < .001 respectively). Finally, those with PAD had reduced septal and posterior wall thickness ( p  < .01, p  = .009 respectively), greater mitral and aortic annular calcification ( p  < .001), and were more affected by previous myocardial infarction ( p  < .001). The PR interval, left anterior fascicular block and aortic root size were independently associated with aneurysm, previous myocardial infarction with PAD, while smaller left ventricular end systolic volumes with carotid artery stenosis. Conclusions: Patients with AAA were mostly affected by cardiac conduction disorders, septal hypertrophy, aortic root dilation and less affected by atrial fibrillation. Patients with CAS were older with more normal sized ventricles, whereas, previous myocardial infarction was most common amongst patients with peripheral artery disease.

Acute thrombotic obstruction of disc valve prosthesis is a rare but catastrophic event without an immediate correct diagnosis and precocious treatment (Amman et al., 1984; Assanelli et al., 1986; Copans et al., 1980; Mann et al., 1986; Gibson et al., 1974; Johnson et al., 1973; Ledain et al., 1986). That is the main reason it is important to consider each helpful sign in order to recognize such a situation. We detected an important dilatation of the right ventricle in two patients with different stages of thrombosis of mitral Björk, the first one had also a chronic dilatation of the right ventricle due to tricuspid regurgitation. The clinical and pathophysiological aspects of these unusual situations are described in this article.

This report describes a case in which serial cross-sectional echocardiographic examinations allowed us to make the diagnosis and to follow anatomical evolution of pulmonary thromboemboli. Frequent (three times a day for seven days) echocardiographic surveillance of thromboemboli allowed us to assess the effectiveness of the therapeutic approach.