1/193. Differential diagnosis of left ventricular mural thrombi by myocardial contrast echocardiography: a preliminary study.Two-dimensional echocardiography has become the procedure of choice to diagnose left ventricular mural thrombi. However, small or flat thrombi may be difficult to distinguish from myocardium. The spatial distribution of the ventricular myocardial blood flow can be imaged with myocardial contrast echocardiography (MCE). The authors presumed that the absence of arterial supply to a fresh thrombus may allow MCE to distinguish between thrombus and myocardium. In the 2 cases presented here, MCE was performed with the same technique as that used for the purpose of visualization of myocardial perfusion; as a result, an apical mural thrombus, indistinct from myocardium before MCE, was visualized as a contrast defect during imaging. Conversely, myocardium that mimicked a thrombus was imaged by MCE as a contrast-opacified area. These findings suggest that MCE after reperfusion therapy is useful to distinguish mural thrombi from myocardium.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
2/193. Post-infarction cardiac rupture.Three allied conditions are described in this paper: (i) haemopericardium with cardiac rupture (5 cases); (ii) haemopericardium without rupture (2 cases); (iii) pseudoaneurysm (1 case). In the first 2 of these, the significant features were clinical deterioration with shock 3 or more days after infarction, recurrent cardiac pain, cardiac tamponade, and immediate or later ineffectiveness of counterpulsation. An additional feature in the second group was the development of haemopericardium after heparin therapy. In the third group, infarction followed by left ventricular failure and progressive cardiac enlargement was the significant feature. An apical systolic murmur was not present, as a false sac had not been formed. Ante-mortem diagnosis depends upon an appreciation of these features. Without it successful surgery is impossible. There were 4 survivors in this group of 8 patients.- - - - - - - - - - ranking = 4.1848647613517keywords = pain (Clic here for more details about this article) |
3/193. Cardiac echinococcosis causing coronary artery disease.We report a case of cardiac echinococcosis in a patient who had sustained an acute myocardial infarction 1 month previously. The coronary angiographic study revealed an isolated complete intrinsic obstruction of the left anterior descending coronary artery in the area of the cyst. The cyst was surgically removed. coronary artery bypass grafting was not performed because of distal myocardial scarring. Coronary arteriography should routinely be performed in all patients with cardiac echinococcosis.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
4/193. Intrapericardial organized hematoma. A rare complication after open heart surgery.Intrapericardial organized hematoma, which compresses cardiac chambers late after open heart surgery, is extremely rare. We report a case of intrapericardial organized hematoma in a 63-year-old man who underwent aortic valve replacement 8 years prior, which may have aggravated rheumatic mitral valve regurgitation compressing the mitral valve anulus. Under extracardiopulmonary bypass and cardioplegic heart arrest, we removed the hematoma and replaced the mitral valve with a 27 mm St. Jude Medical valve. There were no bleeding points on the heart and pericardium at operation and no history of blunt chest trauma. The etiology of the hematoma is uncertain.- - - - - - - - - - ranking = 79.48866293346keywords = chest (Clic here for more details about this article) |
5/193. Neovascularity related to mural thrombus in endomyocardial fibrosis.We report a 30-year old, previously healthy, Ghanese woman admitted with sudden onset of dyspnoe, hemoptoe and right-sided chest pain due to endomyocardial fibrosis with secondary pulmonary emboli coronary angiography revealed a myocardial "blush". This finding may focus attention to the presence of mural thrombus that may have diagnostic and therapeutic consequences.- - - - - - - - - - ranking = 1041.0811092133keywords = chest pain, chest, pain (Clic here for more details about this article) |
6/193. Polyvisceral echinococcosis with involvement of the heart and chest wall: follow-up and review of literature.echinococcosis remains an endemic surgical problem in countries where sheep and cattle raising is carried out, particularly in many Mediterranean countries. The life cycle of echinococcosis is usually marked by the filtration of larvae through the liver and lungs which are the organs most commonly affected by a hydatid cyst. Hydatid cysts in other sites are not common. Cardiac echinococcosis has been reported infrequently even in countries in which hydatid disease is endemic, only isolated sporadic cases have been reported in the literature. Here we report a case of polyvisceral hydatid cyst with involvement of heart and chest wall and reviewed the literature and discussed clinical procedures and management.- - - - - - - - - - ranking = 397.4433146673keywords = chest (Clic here for more details about this article) |
7/193. Traumatic cardiac herniation diagnosed by echocardiography and chest CT scanning: report of a case.A 62-year-old man who had suffered fractures of the left chest wall and hemothorax 1 year earlier was admitted to our hospital with multiple injuries as a result of a traffic accident. Chest drainage was immediately performed under the diagnosis of left hemothorax followed by immobilization of fractures of the femur and radius. On the second day after admission, he suddenly developed severe chest pain and dyspnea after sitting up in bed. echocardiography and chest computed tomography (CT) showed herniation of the left ventricle into the left thoracic cavity, whereby a diagnosis of cardiac herniation due to rupture of the pericardium was made and an emergency surgical repair was successfully performed. Only eight cases of patients surviving after traumatic cardiac herniation have been reported in japan; however, this is the first in which a preoperative diagnosis was made by echocardiography and chest CT scanning prior to surgical repair.- - - - - - - - - - ranking = 1597.5017497475keywords = chest pain, chest, pain (Clic here for more details about this article) |
8/193. Cardiac disease late after chest radiotherapy for Hodgkin's disease: a case report.This report presents a case of occult constrictive pericarditis and mitral valve insufficiency following chest radiotherapy. A 44-year-old man had received radiotherapy for the treatment of Hodgkin's disease 8 years ago. At age 40 years, effusive pericarditis occurred and he was treated with intrapericardial drainage. biopsy revealed a fibrotic and thickened pericardium. He developed congestive heart failure 3 years later. The patient was found to have occult constrictive pericarditis and mitral valve insufficiency. He underwent mitral valve replacement, tricuspid annul plasty, and pericardiectomy. Although there is the benefit of cure for the Hodgkin's disease, the prognosis after treatment is affected by radiotherapy-induced heart disease. After radiotherapy of the chest and mediastinum, long-term cardiological follow-up is recommended in order to detecting patients with radiation-induced heart disease, such as the present case.- - - - - - - - - - ranking = 476.93197760076keywords = chest (Clic here for more details about this article) |
9/193. Velocardiofacial syndrome in childhood-onset schizophrenia.OBJECTIVES: Deletion of chromosome 22q11 (velocardiofacial syndrome) is associated with early neurodevelopmental abnormalities and with schizophrenia in adults. The rate of 22q11 deletions was examined in a series of patients with childhood-onset schizophrenia (COS), in whom early premorbid developmental and cognitive impairments are more pronounced than in adult-onset cases. METHOD: Through extensive recruiting and screening, a cohort of 47 patients was enrolled in a comprehensive study of very-early-onset schizophrenia. All were tested with fluorescence in situ hybridization for deletions on chromosome 22q11. RESULTS: Three (6.4%) of 47 patients were found to have a 22q11 deletion. All 3 COS patients with 22q11 deletions had premorbid impairments of language, motor, and social development, although their physical characteristics varied. brain magnetic resonance imaging revealed increased midbody corpus callosum area and ventricular volume in relation both to healthy controls and to other COS patients. CONCLUSIONS: The rate of 22q11 deletions in COS is higher than in the general population (0.025%, p < .001) and may be higher than reported for adult-onset schizophrenia (2.0%, p = .09). These results suggest that 22q11 deletions may be associated with an earlier age of onset of schizophrenia, possibly mediated by a more salient neurodevelopmental disruption.- - - - - - - - - - ranking = 1keywords = area (Clic here for more details about this article) |
10/193. Cardiac involvement and left ventricular failure in a patient with the churg-strauss syndrome.The churg-strauss syndrome is characterised by a history of asthma and paranasal sinus disease, eosinophilia of more than 10 per cent, non-fixed pulmonary infiltrates on chest radiography and vasculitis which may affect multiple organ systems. The condition usually manifests in the 4th decade. We present a 21-year old female with a history of asthma since one year of age who developed symptoms and signs of pneumonia, a pulmonary infiltrate on chest radiography and eosinophilia. This was followed a few weeks later by vasculitis which affected the skin and myocardium and associated with a peripheral eosinophilia of more than 80%. physical examination revealed palpable purpura and signs of left ventricular failure. echocardiography confirmed significant diminution of left ventricular contractility. A rapid improvement was observed after steroid therapy. echocardiography after two months showed normal left ventricular function. In this presentation we review the cardiac manifestations of the churg-strauss syndrome and its management.- - - - - - - - - - ranking = 158.97732586692keywords = chest (Clic here for more details about this article) |
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