É relatado episódio de acidente vascular encefálico isquêmico em paciente chagásico crônico autóctone da Amazônia. Este é o primeiro caso documentado da forma predominantemente tromboembólica da cardiopatia chagásica crônica na região.

An episode of stroke in a chronic autochthonous chagasic patient from the Brazilian Amazon is reported. This is the first documented case of a predominantly thromboembolic form of chronic Chagasic cardiopathy in the region.

Mulher de 24 anos, portadora de marcapasso dupla câmara, com hipertensão intracraniana e perda visual progressiva, e vários exames de tomografia de crânio inconclusivos. Foi submetida à Ressonância Magnética, mesmo sendo este método diagnóstico uma contra-indicação absoluta em portadores de marcapasso.

The patient is a 24-year-old female with a dual-chamber pacemaker, who had intracranial hypertension, progressive visual loss, and several inconclusive cranial tomographies. She underwent magnetic resonance imaging, even though that diagnostic method is absolutely contraindicated in patients with pacemakers.

The case of a 16-year-old patient with atrioventricular tachycardia caused by a single left anterolateral accessory pathway is reported. When the patient underwent radiofrequency ablation, a lesion on the mitral annulus lateral wall produced changes in the retrograde atrial activation pattern determined by that pathway; changes ranged from a delay in depolarization of the annulus posterior portions to full left atrium counterclockwise activation. Such phenomena were probably caused by a block in the isthmus between the annulus and the lower left pulmonary vein ostium. This case illustrates the importance of the mitral-pulmonary isthmus in the process of left atrium activation, an alert to changes induced by its unintentional block during accessory pathway ablation.