1/22. 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) |
2/22. Combined hyertrophic subaortic stenosis and calcific aortic valvular stenosis.A well documented case of combined hypertrophic subaortic stenosis and calcific aortic stenosis is reported. Detection of multilevel involvement in cases of left ventricular outflow obstruction requires a high index of suspicion and precise hemodynamic and angiographic documentation. Careful analysis of the total data base is necessary for proper management of the patient. The pathogenesis of this combined lesion is unclear: Asymmetrical septal hypertrophy may occur as a consequence of the valvular stenosis, or it may be that abnormal leaflet motion in patients with hypertrophic obstruction produces leaflet thickening, calcification, deformity and stenosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/22. Cystic thymoma simulating contrictive pericarditis. The role of echocardiography in the differential diagnosis.A case is presented of a 60-year-old woman with fatigue, dyspnea, and chest pain. A chest x-ray film revealed an abnormal cardiac silhouette. echocardiography revealed a large, echo-free area with well-demarcated, discrete borders adjacent to the right heart border. This structure decreased in size with inspiration and did not show pulsatile cardiac motion. cardiac catheterization confirmed the extracardiac nature of the lesion and also showed a "constrictive" pattern with equalization of diastolic pressures. Surgical exploration revealed a large cystic thymoma. With removal of the tumor, intracardiac pressures returned to normal.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/22. cor triatriatum: echocardiograhic findings.The echocardiographic findings in a patient with cor triatriatum are presented. The preoperative echocardiogram demonstrated an unusual structure behind the mitral valve that moved anteriorly during atrial systole. There was also echocardiographic evidence of abnormalities of mitral valve motion, right ventricular and left atrial enlargement, and pulmonary hypertension. Postoperatively, the unusual echo behind the mitral valve had disappeared and the mitral valve appeared more normal. Left atrial and right ventricular dimension had decreased and the pulmonary valve appeared more normal. Fine diastolic mitral valve fluttering, an abnormal echo behind the anterior mitral valve leaflet moving anteriorly with atrial systole, an abnormal pulmonary valve echogram suggesting pulmonary hypertension, and marked right ventricular and left atrial enlargement were the main echocardiographic findings in our patient.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/22. Echocardiographic evidence of outflow tract obstruction in Pompe's disease (glycogen storage disease of the heart).A 7 month old black female infant with the clinical findings of Pompe's disease is presented. The diagnosis of an infiltrative myocardiopathy with left ventricular outflow tract obstruction presenting with a pronounced systolic anterior motion of the anterior mitral valve leaflet was made by echocardiography. This diagnosis was confirmed by cardiac catheterization and angiocardiography. Pathologic findings were consistent with Pompe's disease (type II glycogen storage disease). The presence of systolic anterior motion of the mitral valve in this patient suggests that this finding is not pathognomonic of idiopathic hypertrophic subaortic stenosis.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
6/22. echocardiography in mechanical alternans. With a note on the findings in discordant alternans within the left ventricle.We described the echocardiographic manifestations of mechanical alternation of left ventricular (LV) contraction during regular sinus rhythm. Chronic LV dilatation and failure existed in all our four cases. Alternation was observed with respect to the following echocardiographic variables: amplitude and rate of increase of amplitude of systolic excursions of the LV posterior wall and ventricular septum (VS); reciprocal changes in the duration of LV ejection and pre-ejection periods (on the aortic valve echo) such that the total duration of LV electromechanical systole remained constant; reciprocal changes in the duration of RV ejection and pre-ejection periods (on the pulmonic valve echo) such that the total duration of RV electromechanical systole remained constant; systolic anterior excursion of the aortic root as a whole; steepness of the mitral EF slope; septal and LV posterior wall diastolic position; and end-systolic LV diameter. In two patients, discordant alternans of the motion of the LV posterior wall and the VS was observed.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/22. Paradoxical motion of the interventricular septum with right ventricular dilatation in the absence of shunting: report of two cases.A history, heart murmur, electrocardiogram and chest x-ray film suggesting an atrial septal defect associated with an echocardiogram revealing paradoxical motion of the interventricular septum with a dilated right ventricle may be considered indicative of a secundum or primum defect in a young adult or child. Two patients who fulfill all these criteria and had the presumptive diagnosis of an atrial septal defect were found at cardiac catheterization to have no demonstrable left to right shunt or other significant abnormality. The results of standard T-M mode echocardiograms were verified with B scan ultrasonograms. These cases may represent an early stage in the development of a cardiomyopathy. There is no echocardiogram pathognomonic of an atrial septal defect, and patients whose history and echocardiogram suggest this defect should have further diagnostic evaluation including technetium scan or cardiac catheterization.- - - - - - - - - - ranking = 5keywords = motion (Clic here for more details about this article) |
8/22. Echocardiographic patterns in scleroderma.The echocardiograms of two patients with sclerodermatous cardiac disease are described. In one patient the pattern was that of a congestive cardiomyopathy with ventricular dilatation and reduced wall motion. In the second patient the pattern was that of an infiltrative cardiomyopathy with thickened walls and reduced wall motion in the absence of ventricular dilatation. Echocardiographic studies are useful in the early detection of pericardial involvement and primary or secondary myocardial involvement by scleroderma and in following the progression of the disease process.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
9/22. Echocardiographic diagnosis of a pulmonary artery aneurysm.aneurysm of the pulmonary artery is an uncommon anomaly which may be very difficult to diagnose without angiography. The present report demonstrates that the echocardiographic diagnosis of a pulmonary artery aneurysm is feasible. Correlation between chest X-ray, echocardiogram, cardiac catheterization, angiography and necropsy is presented. Several echocardiographic features of the pulmonic valve motion in pulmonary hypertension, not previously described, are discussed.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/22. The plain chest film as an unreliable method to determine left ventricular size.This case report describes the disparity between the findings of the plain chest film and the echocardiogram in a patient with severe coronary artery disease. Whereas the plain chest film shows a normal cardiothoracic ratio of 50% indicating normal LV size, the echocardiogram shows features characteristic of a dilated cardiomyopathic left ventricle with low amplitude of wall motion and consequently low ejection fractoin. These echocardiographic findings were confirmed at cardiac catheterization and angiography. We propose the use of echo instead of the plain chest film in the evaluation of LV size in the cardiac patient.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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