1/14. Perforated aneurysms of left side valves during active infective endocarditis complicating hypertrophic obstructive cardiomyopathy.The most frequent site of vegetative lesion in patients with hypertrophic cardiomyopathy is anterior mitral leaflet, due to chronic endocardial trauma arising from systolic anterior motion. We describe three cases of serious infective endocarditis complicated lesions (vegetation, aneurysm and perforation) on aortic and mitral valves, in patients with obstructive hypertrophic cardiomyopathy. In particular, we observed how severe valvular damage and dysfunction, combined with particular hemodynamic conditions, are followed by adverse clinical outcome. We performed transthoracic echocardiogram and transoesophageal echocardiography studies to define morphologic and hemodynamic features of infection, deciding the proper therapy and we planned the echocardiographic follow-up.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/14. Membranous subaortic stenosis complicated by aneurysm of the membranous septum and mitral valve prolapse.The clinical, echocardiographic, and catheterization findings in a patient with discrete subaortic stenosis, aneurysm of the membranous interventricular septum, and mitral valve prolapse are presented. echocardiography showed a subaortic membrane, abnormal aortic valve motion, accentuated systolic anterior motion of the membranous interventricular septum, and prolapsing mitral leaflets. cardiac catheterization confirmed the diagnoses. The possible functional interrelationship of these lesions is discussed.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
3/14. Acoustic appearance of atrial septal aneurysm.Atrial septal aneurysm in the otherwise normal heart is a very rare and usually asymptomatic condition. A midsystolic click was described as the only clinical manifestation so far. A low-pitched early-to-midsystolic acoustic phenomenon in a 39-year-old woman corresponding with maximal leftward motion of the aneurysmatic interatrial septum during early systole is the subject of this case report. Our experience, plus review of the literature, supports the suggestion that atrial septal aneurysm should be considered in the interpretation of added systolic sounds.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/14. Reconstruction of the left ventricle after previous aneurysmectomy.Two patients recently underwent successful repeat left ventricular anterior aneurysmectomies at our institution. Both patients had undergone a linear repair at first operation. Over time severe heart failure relapsed and echocardiography revealed the recurrence of a voluminous antero-septo-apical aneurysm in both cases, associated with severe mitral regurgitation. Because of still preserved motion of at least three of the basal segments of the left ventricle, a repeat ventriculoplasty according to Dor and a restrictive mitral valve annuloplasty was attempted. At 6-month follow-up, the patients were in the new york Heart association functional class I and II, respectively. Left ventricular end-diastolic diameters decreased from 73 mm to 67 mm and from 81 mm to 52 mm, and left ventricular end-systolic diameters from 61 mm to 54 mm and from 70 mm to 34 mm. Mitral regurgitation was absent.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/14. Familial aneurysms of the interventricular septum.Congenital aneurysms of the interventricular septum were found in a 29 year old man and his four year old son. Both were symptom free. In both, M mode and cross sectional echocardiography showed an aneurysm in the mid-muscular trabecular portion of the ventricular septum with considerable paradoxical motion of the aneurysmal segment. Otherwise the chamber dimensions, intracardiac structures, and cardiac function were normal for age. Congenital aneurysm of the interventricular septum is rare and these familial cases may be unique.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/14. Echocardiographic findings in ventricular septal rupture and anterior wall aneurysm complicating myocardial infarction.Echocardiographic findings in a patient with ventricular septal rupture and anterolateral wall aneurysm complicating myocardial infarction are presented. The findings were confirmed by cardiac catheterization and surgery. Using M-mode ultrasonocardiography one was able to demonstrate and localize the aneurysm as well as the ventricular septal defect which presented as an oblique interventricular communication appearing only during systole. Thus echocardiography supplemented the invasive examinations in exactly revealing the site of ventricular septal rupture. Other echocardiographic features of ventricular septal rupture were right ventricular dilatation, pathological septal motion and abnormal tricuspid valve motion as recently reported by other authors.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
7/14. Gated blood-pool emission tomography: a new technique for the investigation of cardiac structure and function.ECG-gated single-photon emission-computed tomography of the intracardiac blood pool is a new technique that has not previously been widely applied. It involves the acquisition of ECG-gated images of the intracardiac blood pools labelled with sodium pertechnetate tc 99m in 32 projections around the left-anterior hemithorax using a rotating gamma camera. From these images, tomographic sections are reconstructed orthogonal to the long axis of the left ventricle. The heart is therefore imaged three dimensionally, and more extensive information is obtained than in planar radionuclide ventriculography where imaging is usually restricted to only a single projection. Both structure and function can be studied, and the left-ventricular volume and ejection fraction, and wall motion are obtained. Of 50 patients studied, 7 cases are illustrated in order to show normal findings, examples of wall motion that were not shown by planar-contrast and radionuclide ventriculography, examples of the localisation of ventricular hypertrophy, and a comparison between blood-pool and 201TI myocardial tomography.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
8/14. A case of left ventricular aneurysm associated with an anomalous coronary artery.A 54-year-old man presented with continual angina pectoris at rest, associated with an anomalous coronary artery. He also had an aneurysm at the submitral region of the left ventricular postero-lateral wall, without evidence or prior myocardial infarction, which showed hypokinetic inward motion during systole. We assume that this was a rare case of left ventricular aneurysm without prior myocardial infarction, the etiology which might related to the anomalous coronary artery.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/14. Five cases of arrhythmogenic left ventricular aneurysm unrelated to coronary occlusion.Five among 19 cases of sustained ventricular tachycardia (VT) treated in the last two years had left ventricular aneurysms, but the patients denied any previous attack of chest pains that would indicate acute myocardial infarction. Laboratory findings including serum electrolytes were normal and no signs of inflammation were found. Coronary angiograms were normal but the left ventriculograms showed aneurysms in four patients and akinetic to aneurysmal wall motion in one patient. Electrophysiologic studies (EPS) were done in four patients. VT was induced reproducibly by programmed electrical stimulation in three patients and it was terminated by programmed stimulation within 30 seconds. The foci of VT were determined by EPS. One case who showed acceleration of the VT rate following the second induction of VT developed a fulminant course; Adams-Stokes attacks from VT, more than ten times a night in spite of intravenous administration of a large dose of procainamide, were terminated by DC shock. VT was determined to originate from the aneurysm that was resected operatively. In the other two cases, the foci were resected and the intraoperative EPS confirmed the preoperative foci. The postoperative EPS showed no inducibility of VT in three surgical cases. Though the induction of VT may not be indicated in every case of VT, we believe that EPS is required to determine the focus for the operation and to evaluate the precise drug efficacy in rapid VT. It is further stressed that the sustained VT of our patients including the present five, lasted for several hours until it was terminated in the hospital.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/14. Atrial septal aneurysm--a potential cause of systemic embolism. An echocardiographic study.Atrial septal aneurysm is an uncommon condition. Between 1981 and 1984 10 cases of atrial septal aneurysm were diagnosed by real time cross sectional echocardiography performed in 4840 patients. The aneurysm was associated either with mitral valve prolapse (three patients) or with atrial septal defect (three patients) or occurred in isolation (four patients, two of whom had had a previous embolic event leading to the diagnosis of atrial septal aneurysm by cross sectional echocardiography). During cross sectional echocardiography the aneurysm appeared as a localised bulging of the interatrial septum, which was best seen in the subcostal four chamber view and in the parasternal short axis view at the level of the aortic root. The aneurysm either protruded into only the right atrium (five patients) or moved backwards and forwards between the right and the left atria during the cardiac cycle (five patients). This motion pattern might be related to changes in the interatrial pressure gradient. The two patients who had had a systemic embolism were given anticoagulant treatment, but none underwent surgery. It is concluded that the true prevalence of atrial septal aneurysm might have been underestimated before the routine use of cross sectional echocardiography, that cross sectional echocardiography enables definitive diagnosis of this condition by a non-invasive technique, and that an atrial septal aneurysm should be suspected and looked for by cross sectional echocardiography after an unexplained systemic embolism.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
| | Next -> |