1/12. Clinical manifestation and survival of patients with idiopathic bilateral atrial dilatation.We studied the histories of eight patients who lacked clear evidence of cardiac abnormalities other than marked bilateral atrial dilatation and atrial fibrillation, which have rarely been discussed in the literature. From the time of their first visit to our hospital, the patients' chest radiographs and electrocardiograms showed markedly enlarged cardiac silhouettes and atrial fibrillation, respectively. Each patient's echocardiogram showed a marked bilateral atrial dilatation with almost normal wall motion of both ventricles. In one patient, inflammatory change was demonstrated by cardiac catheterization and endomyocardial biopsy from the right ventricle. Seven of our eight cases were elderly women. Over a long period after the diagnosis of cardiomegaly or arrhythmia, diuretics or digitalis offered good results in the treatment of edema and congestion in these patients. In view of the clinical courses included in the present study, we conclude that this disorder has a good prognosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/12. Mechanism of atrial sounds in atrial fibrillation. Phonoechocardiographic correlation. Report of a case.Audible atrial sounds were noted in a patient with congestive cardiomyopathy and atrial fibrillation with slow ventricular rate. Oscillatory motion of similar periodicity as fibrillation waves in the ECG and the sounds in the phonocardiogram was demonstrated in aortic and left ventricular walls, mitral, tricuspid and aortic leaflets by echocardiography. This suggests that the fibrillation motion of the atria is forceful enough to cause vibration of the cardiohemic system resulting in the audible sounds.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
3/12. Cardiac wall motion abnormalities observed in a patient with transient hyperthyroidism.A 74-year-old woman, with a history of hypertension and hyperlipidemia, was admitted to our hospital. She was found to have a sinus tachycardia with ST-segment elevations in leads II, III, (a)V(F), and V(3) through V(6) in electrocardiography, hypokinesis of the left ventricular apex by echocardiography, and normal findings on coronary angiography. Blood analysis revealed an increase in the creatine kinase MB fraction, a significant positive detection in troponin t, and transient elevations in the concentrations of free triiodothyronine, free thyroxine, thyroid globulin antibody, and thyroid peroxidase antibody. Defects in myocardial perfusion and fatty acid metabolism in the apical area were also demonstrated by myocardial scintigraphy. These data suggest that tako-tsubo syndrome or myocardial infarction may be induced in patients with mild and transient hyperthyroidism.- - - - - - - - - - ranking = 4keywords = motion (Clic here for more details about this article) |
4/12. Minimally invasive atrial fibrillation ablation combined with a new technique for thoracoscopic stapling of the left atrial appendage: case report.BACKGROUND: Surgical therapy for atrial fibrillation (AF) is becoming increasingly popular in the concomitant setting. Minimally invasive techniques are being developed for management of the patient with stand-alone AF. We report on our first case of a patient undergoing thoracoscopic microwave epicardial AF ablation combined with the incorporation of a new device for left atrial appendage (LAA) exclusion. methods: The patient is a 62-year-old man with a 10-year history of drug-resistant paroxysmal AF. He had failed multiple electrical cardioversions, as well as a percutaneous attempt at left and right superior pulmonary vein (PV) isolation. On October 8, 2003, he was admitted to undergo an off-pump thoracoscopic epicardial microwave ablation. While the patient was under general anesthesia, 3 thoracoscopic access ports were created in the right chest. The pericardium was widely opened. Red rubber catheters were positioned in the transverse and oblique sinuses. The 2 catheters were retrieved on the left side and tied together, forming a guide to the Flex 10 microwave ablation probe (Guidant Corporation, Fremont, CA, USA). The Flex 10 sheath was positioned to encircle all 4 pulmonary veins. The position of the ablation catheter was confirmed visually to be behind the LAA. Sequential ablation was then performed in the segments of the Flex 10 to create a continuous ablation line around the PVs. A connecting lesion to the base of the LAA was then performed. The LAA was then stapled using the SurgASSIST computer-mediated thoracoscopic stapling system (Power Medical Intervention, New hope, PA, USA). RESULTS: The procedure was uneventful and lasted for a total of 2.5 hours. The patient was discharged home on postoperative day 2 in rate-controlled AF. He was successfully electrically cardioverted to normal sinus rhythm (NSR). At latest follow-up he remained in NSR and continued to take dofetilide (Tikosyn). CONCLUSION: Thoracoscopic epicardial microwave ablation of AF is a technically feasible procedure with minimal risk. The computer deployment and motion controlled stapling system that we used in this case has the potential to become a safe and reliable alternative to conventional stapling instruments.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/12. Ocular ichemia syndrome - a malignant course of giant cell arteritis.PURPOSE: To call attention to a malignant course of ocular ischemic syndrome in patients with giant cell arteritis (GCA). methods/PATIENT: A 84-year-old woman developed severe headache for about 3 (1/2) months prior to myocardial infarction and visual disturbances. RESULTS: An anterior ischemic optic neuropathy (AION) in the right eye with a distinct reduction in visual acuity was found. The retina revealed several cotton-wool spots in both eyes. Serologic examinations showed inflammatory signs. Despite treatment with prednisolone, eye pressure decreased to 2 mm Hg in the right eye and 4 mm Hg in the left eye in a few days. An ischemic iritis developed in the right eye. visual acuity worsened to detection of hand motions in the right eye and to 0.1 in the left eye. Approximately 8 (1/2) months after her initial headache, a biopsy was carried out. The patient was treated continuously with corticosteroids. histology of the superficial temporal artery indicated inflammatory cells in the vessel wall. - The patients daughter developed symptoms of GCA at the age of 54 years. CONCLUSION: An ocular ischemic syndrome points to a malignant course of the disease. A cardiac infarction can develop in GCA. A biopsy of the temporal artery can reveal inflammatory changes even after 8 (1/2) months.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/12. Segmental atrial fibrillation resulting in chronic atrial dissociation. A case report.Atrial arrhythmias are diagnosed on the basis of the analysis of P wave morphology, timing and rate, the surface electrocardiogram, and intracardiac recordings. Recent intracardiac studies have demonstrated dissimilar atrial rhythms with direct intra-atrial recordings, the former otherwise not evident on the surface ECG (Zipes et al. 1972, Wu et al. 1975, Friedman et al. 1974, Gomes et al. 1981). This paper reports the electrocardiographic diagnosis of atrial dissociation made on the surface electrocardiogram. The findings suggest the following: (1) That sinus rhythm exists, with the dominant sinus rhythm depolarizing the major portion of the right as well as the left atrium; (2) atrial fibrillation localized specifically to lead III, and at times to leads III and AVL, on the surface electrocardiogram; and (3) Intraesophageal recordings and echocardiography revealed an area of the posterior right and left atria that had wall motion abnormalities and electrical activity compatible with those of atrial fibrillation.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/12. Catecholamine induced double tachycardia: case report in a child.A six-year-old girl with syncope in association with atrial flutter-fibrillation and ventricular tachycardia produced by exercise or emotion is presented. The tachycardias could be reproduced by low-dose isoproterenol infusion and were blocked by high dose propranolol therapy. Catecholamine-induced tachyarrhythmias should be suspected in children with unexplained syncope in association with exercise or emotion.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
8/12. Atrial infarction complicating an acute inferior myocardial infarction.atrial fibrillation, coronary sinus rhythm, and slow atrial flutter developed in a patient with ECG findings of an acute inferior myocardial infarction. Hemodynamic measurements were suggestive of predominantly right ventricular involvement. A gated cardiac blood pool study demonstrated normal right and left ventricular wall motion with an enlarged, non-contracting right atrium. This led to the antemortem diagnosis of atrial fibrillation.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/12. Double diastolic murmur in mitral stenosis with atrial fibrillation and complete heart block.A double diastolic murmur was heard in a patient with mitral stenosis, atrial fibrillation, and complete heart block. Echo-phonocardiographic examination showed two separate opening and closing movements of the mitral valve in the same long diastole. A clear time relation was observed between the valve closing movements and the separate diastolic murmurs, giving support to the theory that the backward motion of the mitral valve against the forward blood flow through the valve is responsible for the production of these murmurs.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/12. Supraventricular arrhythmia as the cause of sudden death in hypertrophic cardiomyopathy.Electrophysiological studies with simultaneous echocardiographic control and invasive measurement of intravascular pressures were carried out in a 13-year-old boy with hypertrophic cardiomyopathy who was hospitalized after an episode of aborted sudden death. Ventricular stimulation did not induce ventricular tachycardia, but atrial stimulation induced atrial fibrillation, atrial flutter and non-sustained ventricular tachycardia. Atrial stimulation (S1) at 200 beats.min-1 (10-15 s) also induced significant repolarization abnormalities in the 5-10 post-stimulation beats. Akinesia of the ventricular septum and posterior wall without opening of the mitral valve was documented by echocardiography. A complete anterior systolic motion, not observed under basal conditions, was detected in the first post-stimulation beat. Atrial stimulation at rates over 120 beats.min-1 caused a drop in systolic blood pressure, a rise in pulmonary artery pressure, and a decrease in cardiac output. Despite therapy with propranolol and amiodarone, the patient died suddenly.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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