11/14. Echocardiographic features of a mycotic aneurysm of the left ventricular outflow tract caused by perforation of mitral-aortic intervalvular fibrosa.We present the apparently unique M-mode and two-dimensional echocardiographic features of a surgically confirmed pseudoaneurysm of the left ventricular outflow tract, which probably developed as a result of perforation of the mitral-aortic intervalvular fibrosa. Echocardiographic studies revealed an aneurysmal sac situated between the aortic root and the left atrium. The aneurysm expanded in systole and collapsed or emptied in diastole, suggesting direct communication with the left ventricle. Such an aneurysm must be differentiated from various pathologic findings of the aortic root. The location and characteristic motion during the cardiac cycle should alert the clinician to the correct diagnosis of such an aneurysm.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
12/14. Early aortic valve closure in combined idiopathic hypertrophic subaortic stenosis and discrete subaortic stenosis.A patient with idiopathic hypertrophic subaortic stenosis (90 mm Hg resting intraventricular gradient) and discrete subaortic stenosis was found to have two separate systolic closing movements of the aortic valve on M mode echocardiography, each movement being associated with a separate systolic ejection murmur. The first closing movement occurred early in systole and was attributed to alterations in flow across the discrete stenosis. The second closing movement coincided with a later systolic murmur and systolic anterior motion of the mitral valve. The case supports the concept that timing of early closing movements of the aortic valve is useful in the diagnosis of subvalvular obstruction.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
13/14. Echocardiographic features of second degree atrioventricular block.Echocardiographic studies demonstrated abnormalities of motion of the pulmonary valve, the aortic root and valve, the mitral and tricuspid valves, the left ventricle, and the left atrium in two patients with second-degree atrioventricular block. During Wenckebach 3:2 atrioventricular conduction, ventricular beats exhibited alternately long and short periods of systolic opening of the pulmonary and aortic valves and alternately large and small left ventricular stroke volumes. During 4:3 and 3:2 Wenckebach atrioventricular conduction, the left ventricular stroke volume was directly proportional to the preceding end-diastolic volume. During 2:1 atrioventricular conduction, the blocked atrial contractions may produce movements of the left atrial wall, thereby revealing the true atrial rate when the blocked P waves are obscured in the electrocardiogram by their superimposition on preceding T waves.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
14/14. MR findings in Shone's complex of left heart obstructive lesions.BACKGROUND: Shone's complex is a series of four obstructive or potentially obstructive left-sided cardiac lesions (supravalvular mitral ring, parachute deformity of the mitral value, subaortic stenosis, and coarctation of the aorta). Both the complete form (all four lesions) and incomplete forms (less than four lesions) have been described. OBJECTIVE: To determine which abnormalities of Shone's complex could be characterized by MR. MATERIALS AND methods: MR examinations in three patients (one complete, two incomplete) were retrospectively reviewed. RESULTS: A supravalvular mitral ring, found at surgery in one patient, was not identified. Regurgitant and stenotic flow across the mitral valve, abnormal motion of the valve leaflets and abnormalities of the papillary muscles were identified. Individual chordal attachments were difficult to resolve. Narrowing in the subaortic region and abnormal flow from the subaortic region through the valve plane were demonstrated. A discrete subaortic diaphragm in one patient was not resolved. Both focal and diffuse types of coarctation of the aorta were well characterized. CONCLUSION: MR imaging is suited to evaluation of patients with Shone's complex. Individual chordal attachments and thin diaphragms of the mitral and aortic valves were difficult to resolve.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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