1/4. Expeditious diagnosis of primary prosthetic valve failure.Primary prosthetic valve failure is a catastrophic complication of prosthetic valves. Expeditious diagnosis of this complication is crucial because survival time is minutes to hours after valvular dysfunction. The only life-saving therapy for primary prosthetic valve failure is immediate surgical intervention for valve replacement. Because primary prosthetic valve failure rarely occurs, most physicians do not have experience with such patients and appropriate diagnosis and management may be delayed. A case is presented of a patient with primary prosthetic valve failure. This case illustrates how rapidly such a patient can deteriorate. This report discusses how recognition of key findings on history, physical examination, and plain chest radiography can lead to a rapid diagnosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. Tricuspid stenosis: a rare cause of heart failure in the united states.The authors describe the case of a 72-year-old patient who has a history of rheumatic heart disease and had mitral valve replacement in childhood. She presents with progressive right-sided heart failure unresponsive to medical therapy. On evaluation she was found to have severe aortic stenosis and severe tricuspid stenosis. Surgical correction of both valves resulted in complete resolution of heart failure with remarkable improvement in quality of life. The symptoms, physical findings, and treatment options will be discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/4. Pericardial disease in rheumatoid arthritis.Six patients with rheumatoid constrictive pericarditis, five seen in a two and one half year period, are described. All patients were male, all had rheumatoid factor, and all had active arthritis. diagnosis was suspected from careful physical examination and confirmed in five patients by cardiac catheterization. pericardiectomy was successful in all five patients on whom it was performed. Rheumatoid constrictive pericarditis should be suspected in any patient with rheumatoid arthritis and unexplained signs of right heart failure.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. Case report: trivalvular rheumatic stenosis: documentation of disease progression by serial cardiac catheterization.A 56-year-old female with known rheumatic tricuspid stenosis was admitted for treatment of palpitations, abdominal discomfort and supraventricular tachyarrhythmias. Twenty years after an initial study, cardiac catheterization disclosed additional mitral and aortic stenoses. Trivalve prosthetic replacement was recommended, but cardiac arrest occurred, allowing pathologic confirmation of the hemodynamic findings. documentation of disease progression in nonoperated multivalvular rheumatic heart disease by cardiac catheterizations over such extended intervals of time has not previously been described. Also, the clinician is warned that historical and physical signs in such cases can underplay the actual severity and extent of disease, and he should not, therefore, be misled by unimpressive findings that the valvular deformity is insignificant.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |