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Percutaneous central venous catheterization through the femoral vein is frequently used in the Coronary Care Unit. Complications such as thrombophlebitis, thromboembolism and femoral artery puncture are rare. We describe a case of arteriovenous fistula due to femoral vein catheterization in a 61 year old man who was admitted because of advanced atrioventricular block. Auscultation revealed a systodiastolic murmur. Two dimensional and color Doppler flow imaging demonstrated an arteriovenous communication between the superficial femoral artery and common femoral vein without hemodinamic consequences. Two months later, on physical examination and Doppler investigation, the fistula had disappeared.

A series of 5 males and 2 females aged 23-73 yr with carcinoid cardiopathy is presented, all of them with clinical and instrumental signs of liver metastasis. The main clinical signs were dyspnoea and asthenia rendered ingravescent by effort, and, in the later stage, a frank picture of congestive cardiac decompensation. All subjected presented stethoscopic evidence of tricuspid valvulopathy, combined with pulmonary stenosis in 2 cases. The ECG picture displayed a constant reduction in cardiac potentials, together with right branch bundle block in 3 cases. In cases where an echocardiogram was taken, this confirmed tricuspid involvement. The disease progressed in all cases, and four patients died as a result of terminal liver failure.

3600 dynamic ecg recordings were carried out over a period of about seven years. In 408 cases (11.3%), indication for the investigation consisted of syncopal or equivalent minor episodes. 37 patients (9%) presented symptoms during the recording; in 12 cases (2.9%), the symptoms corresponded to an arrhythmia. An increase in atrial and ventricular arrhythmias with advancing age was also observed. Owing to the high incidence of arrhythmias in the elderly, and the poor correlation between symptoms and significant arrhythmias, dynamic ecg is therefore of little diagnostic value in syncope patients.

Cardiac myxoma are a diagnostic dilemma, simulating a variety of cardiac and non cardiac diseases. Echocardiography is a powerful technique for diagnosing primary tumors of the heart. We report two cases of elderly patients, with atrial myxomas, for which operation was safely performed on the basis of echocardiography alone without preoperative catheterization.