11/15. Echocardiographic studies of the human fetus: prenatal diagnosis of congenital heart disease and cardiac dysrhythmias.During obstetrical ultrasound examinations, 200 M-mode and 35 real-time two-dimensional echocardiographic studies were performed on 180 fetuses of high-risk pregnancies. Fetal gestational ages ranged from 18 to 41 weeks. M-mode "sweeps" demonstrating mitral- and septal-aortic fibrous continuity were obtained in 115 studies. Paradoxic septal motion in 50 fetuses suggested relarive right ventricular volume loading. Congenital cardiac malformations were accurately diagnosed in a 34-week fetus with pulmonary atresia and hypoplastic right ventricle and in a 28-week fetus with a univentricular heart. Congenital complete atrioventricular block was diagnosed in a 28-week fetus and atrial flutter with variable atrioventricular block was diagnosed in a 38-week fetus. The use of echocardiographic studies to evaluate cardiac structure and rhythm in utero assists in counseling prospective parents and in planning postnatal management for their offspring.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
12/15. technetium-99m methoxy isobutyl isonitrile simultaneous evaluation of ventricular function and myocardial perfusion in patients with congenital heart disease.The authors evaluated the clinical applications of Tc-99m methoxy isobutyl isonitrile (MIBI) in the simultaneous assessment of ventricular function and myocardial perfusion in patients with congenital heart disease. Global ventricular function was assessed by first-pass ECG gated study. Myocardial perfusion was evaluated on images performed 1 hour after the injection of the tracer. Regional wall motion and systolic thickening were assessed by gated study acquired after the perfusion study. Two young patients were studied after a surgical Glenn procedure. The first patient, with a history of transposition of the great vessels and univentricular heart, had an ejection fraction of 44%. The left ventricle was dilated and the right ventricle was not appreciable. The septal and inferoapical regions showed reduced perfusion and reduced systolic thickening. The second patient, with a history of pulmonary atresia, septal defect and left ventricular hypoplasia, had a right ventricular ejection fraction of 37%. Regional wall motion, systolic thickening, and myocardial perfusion were normal. The right ventricle was hypertrophic and larger than the left ventricle. Thus, a single injection of Tc-99m MIBI allows noninvasive simultaneous assessment of global and regional ventricular function and myocardial perfusion in young patients with complicated congenital heart disease.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
13/15. A parents' perspective: our needs and our message.This article, written by parents, describes their fears and frustrations as the child they love is taken from the joyful family life that had been expected, to the terror of facing the possibility of death in a critical care situation. The parents want to help the medical team in healing their child, yet find themselves in a totally foreign environment in which they are often ineffective. By sharing the feelings experienced during their child's initial diagnosis and treatment, the authors hope that health care professionals will understand better the emotions parents are feeling and that parents can be helped to overcome their fears in order to better assume their role as part of the critical care treatment process.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
14/15. Right ventricular regional wall motion abnormality in congenital heart disease.Four cases of congenital heart disease with right ventricular overload and echocardiographic evidence of persistent right ventricular regional wall motion abnormalities are presented. Right ventricular infarction could be a possibility. Such regional wall motion abnormalities could add to overall right ventricular dysfunction in these cases. echocardiography is useful in diagnosis. Right ventricular wall motion abnormalities should be studied in detail in all cases of congenital heart disease with right ventricular overload.- - - - - - - - - - ranking = 7keywords = motion (Clic here for more details about this article) |
15/15. The 'sail sound' and tricuspid regurgitation in Ebstein's anomaly: the value of echocardiography in evaluating their mechanisms.We describe a patient with Ebstein's anomaly in whom Doppler echocardiography was used to clarify the mechanism responsible for 'sail sound' and tricuspid regurgitation associated with this condition. phonocardiography revealed an additional early systolic heart sound, consisting of a first low-amplitude component (T1) and a second high-amplitude component (T2, 'sail sound'). In simultaneous recordings of the tricuspid valve motion using M mode echocardiography and phonocardiography, the closing of the tricuspid valve occurred with T1 which originated at the tip of the tricuspid leaflets, while T2 originated from the body of the tricuspid leaflets. Using color Doppler imaging, the tricuspid regurgitant signal was detected during pansystole, indicating a blue signal during the phase corresponding to T1 and a mosaic signal during the phase corresponding to T2 at end-systole. Thus, 'sail sound' in patients with Ebstein's anomaly is not simply a closing sound of the tricuspid valve, but a complex closing sound which includes a sudden stopping sound after the anterior and/or other tricuspid leaflets balloon out at systole.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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