1/11. Echocardiographic manifestations of aortic cusp rupture in a myxomatous aortic valve.A 16-year-old pregnant black girl who had spontaneous perforation of the aortic valve associated with myxomatous aortic valvular degeneration is presented. The echocardiogram revealed chaotic systolic motion of one of the aortic cusps, diastolic aortic valvular fluttering, and abnormal diastolic echoes in the left ventricular outflow tract. The report illustrates that the echocardiographic features associated with valvular vegetations are not specific for infectious endocarditis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/11. Juxta-articular myxoma: a rare cause of painful restricted motion of the knee.A 68-year-old athletic woman presented to our institution in January 2002 with a several-month history of progressing complaints of pain, swelling, and loss of motion in the right knee. These manifestations had begun the previous July during a game of tennis. She experienced persisting pain and recurring effusions. Because the patient had been residing in another state between July and January, rheumatologic and orthopaedic evaluations of the knee, including a magnetic resonance imaging (MRI), had been performed at a geographically distant (but affiliated) institution. The resulting presumptive diagnosis was a "wear and tear" degenerative articular disorder of the knee. A program of anti-inflammatory medication and physical therapy was begun for several months but produced no therapeutic benefit by the time the patient presented at our institution. After examination confirmed marked losses of both flexion and extension of the knee, effusion, and exquisite medial joint tenderness, an MRI was repeated, using intra-articular gadolinium as a contrast agent. It revealed an intra-articular mass encircling the medial and posterior extents of the medial femoral condyle. An arthroscopic multiportal excisional biopsy was performed. It revealed the existence of a juxta-articular myxoma. The patient recovered most of the range of motion during the next several months, and the effusion and severe pain gradually dissipated. The patient was subsequently followed by sequential physical examinations and MRIs, performed at increasing intervals of time, without recurrence of a mass or of her flagrant symptoms in the first year post surgery. Though the patient's diagnosis was established and treatment outcome was satisfactory, many issues were brought up in this case regarding most appropriate selection of diagnostic tests and treatment approaches.- - - - - - - - - - ranking = 6keywords = motion (Clic here for more details about this article) |
3/11. Severe left ventricular dysfunction in left atrial myxoma--report of 2 cases.We report 2 patients with left atrial (LA) myxoma with associated severe left ventricular (LV) dysfunction. Both presented with progressive effort intolerance without a history suggestive of acute coronary event. LA myxoma was diagnosed by transthoracic echocardiography, which also detected severe systolic dysfunction and LV dilatation. Regional wall motion abnormality and thinning were absent. Coronary angiograms also showed no occlusive disease, but distal ectasia was seen in 1 patient. Metabolic and endocrine causes of reversible LV dysfunction were excluded. Cardiac function improved following surgery for myxoma in 1 patient. LV dysfunction, thus far, has not been directly attributed to myxoma. Coronary embolization leading to myocardial infarction and coexisting coronary atherosclerosis are the recognized methods by which LV dysfunction manifests in myxoma. Our report suggests the possibility of reversible severe global LV dysfunction due to cardiodepressant effect of myxoma through as yet unclear mechanisms.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/11. Abnormal left ventricular catheter motion: an ancillary angiographic sign of left atrial myxoma.The normal motion of a left ventricular catheter parallels that of the aortic root; it moves anterior during systole and posterior during diastole. In contrast, a prolapsing left atrial myxoma causes paradoxical motion of the catheter; posterior during systole and anterior during diastole. Paradoxical motion was found in each of five cases of prolapsing left atrial myxoma (no false negatives), and in six out of 61 controls (six false positives). In the false positive cases, the catheter was not positioned on the ventricular floor and usually only minor degrees of abnormal motion were present. Paradoxical motion of the left ventricular catheter is an ancillary angiographic finding in prolapsing left atrial tumor.- - - - - - - - - - ranking = 9keywords = motion (Clic here for more details about this article) |
5/11. The etiology of tumor plop in a patient with huge right atrial myxoma.In a patient with a large atrial myxoma, the phonocardiographic timing of the tumor plop has been correlated with the two-dimensional echocardiographic motion pattern of the cardiac mass. The tumor plop occurred at the time when the mass stopped its diastolic forward motion into the ventricle and made a strong impact on the interventricular septum and right ventricular posterior wall. Occurrence of tumor plop may require a large mass or long enough tumor stalk to allow the impact of the mass on the ventricular wall.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
6/11. Detection of left atrial myxoma with SPECT cardiac imaging.A 69-year-old man with a left atrial myxoma underwent a gated cardiac blood pool radionuclide study that failed to visualize the cardiac tumor on either the planar images or on the composite cineangiograms from the anterior and 45 degrees LAO projections. A nongated cardiac SPECT examination, however, easily demonstrated the atrial myxoma in its characteristic location, adjacent to the interatrial septum. SPECT dramatically improved the image contrast; provided views in transaxial, coronal, and sagittal planes; and allowed direct comparison with computed tomography. Gated cardiac SPECT may be expected to provide a more accurate analysis of the complex motion and attachment site of these intracardiac tumors, as well as a more accurate tumor volume analysis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/11. Abnormal diastolic movement of the interventricular septum caused by a prolapsing right atrial myxoma.A 40 year old woman with cough and exertional dyspnoea was found to have a large right atrial myxoma by M mode and cross sectional echocardiography. prolapse of the tumour into the right ventricle occurred during diastole with sufficient force to cause mechanical distortion of the interventricular septum. Septal motion became normal after surgical resection of the myxoma.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/11. Ultrasonic demonstration of right ventricular myxoma.A case of right ventricular myxoma masquerading as infundibular pulmonic stenosis with right-sided heart failure is presented. The unsuspected tumor was diagnosed with two-dimensional multicrystal real time scanning and single element echocardiography. Direct visualization of the tumor anatomy and its spatial relationships on cross-sectional images facilitates the diagnosis. On the other hand, the more accurate motion analysis form the time-motion display of the echo data yields additional functional information. Thus the two techniques are complementary to establish a diagnosis in those disorders where anatomy and function overlap. Ultrasonic examination yields a practical solution to the problem of screening patients to detect intracardiac tumors. This painless, noninvasive examination should be included in the analysis of every patient with cardiac symptoms.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
9/11. Left atrial myxoma: phonocardiographic, echocardiographic, and micromanometric hemodynamic correlations.We used simultaneous echocardiography, phonocardiography, and high-fidelity micromanometry to investigate the impact of the movement of a large pedunculated left atrial myxoma on hemodynamics. The case we have described shows that (1) the early diastolic sound (tumor plop) coincided with maximal excursion of the tumor in the left ventricular inflow tract, (2) tumor movements during mid to late diastole corresponded to low-frequency oscillations in left ventricular pressure, (3) tumor expulsion from the left ventricle into the left atrium was initiated during "isovolumic" contraction but continued into the early ejection phase, (4) mitral valve closure was abnormally delayed until after the onset of aortic ejection, and (5) systolic ejection was initiated before coaptation of the mitral valve leaflets. These findings support the theory that tumor motion contributes to both systolic and diastolic vibrations of the entire cardiohemic system.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/11. Correlation of phono- and apexcardiographic findings with tumor motion in left atrial myxoma.We have analyzed the genesis of physical signs in a case of prolapsing left atrial myxoma by simultaneous phono-, apex- and M-mode echocardiography. Our findings confirm a direct relationship of tumor movements with notching in the upstroke of the apexcardiogram and with the protodiastolic "tumor plop."- - - - - - - - - - ranking = 4keywords = motion (Clic here for more details about this article) |
| | Next -> |