1/191. Mitral valve repair for anterior leaflet papillary fibroelastoma: two case descriptions and a literature review.Cardiac papillary fibroelastomas are rare cardiac tumors and have been considered a 'benign' incidental finding that may have significant clinical manifestations. In this paper we report two cases of mitral valve fibroelastoma: one was discovered by chance with transthoracic echocardiography in a young healthy man, the other was an intraoperative incidental finding in a middle aged man with a recent history of acute myocardial infarction. The mitral valve was repaired in both cases after excising the tumor. The patients did well and remain asymptomatic. A literature review was compiled which comprises previous case reports of 34 patients with mitral valve papillary fibroelastomas. Most were asymptomatic, but when symptoms occurred, they could be disabling, such as stroke, cardiac heart failure, myocardial infarction, and sudden death. Papillary fibroelastoma is amenable to simple surgical excision or in addition to mitral valve repair or replacement. recurrence has not been reported.- - - - - - - - - - ranking = 1keywords = cardiac, sudden death, sudden, death (Clic here for more details about this article) |
2/191. Cardiac papillary fibroelastoma: report of two cases.We report 2 cases of cardiac papillary fibroelastoma in aortic position that were successfully treated by complete surgical excision, without damage to the aortic valve. This rare cardiac tumor can be associated with serious embolic or hemodynamic complications and therefore, prompt surgical intervention is required.- - - - - - - - - - ranking = 0.95217751836083keywords = cardiac (Clic here for more details about this article) |
3/191. Papillary fibroelastoma of the mitral valve 12 years after mitral valve commissurotomy.A 63 year-old woman who had had mitral valve commissurotomy 12 years earlier was seen because of rheumatic mitral stenosis and left brachial paresis due to cerebral embolism. On clinical evaluation, a diastolic rumble was heard over the mitral area, and the echocardiogram revealed a mass attached to the mitral subvalvular apparatus. The patient was operated on, and both the surgical and histologic findings depicted papillary fibroelastoma. This tumor may occur as an isolated lesion or be associated with mitral valve stenosis or other cardiac abnormalities, and it is an important source of emboli. Early echocardiographic diagnosis, followed by surgical excision, may avoid serious complications such as stroke, myocardial infarction, and sudden death.- - - - - - - - - - ranking = 0.52391124081959keywords = cardiac, sudden death, sudden, death (Clic here for more details about this article) |
4/191. A cardiac papillary fibroelastoma with chordal location.Papillary fibroelastomas, which were initially incidental findings at autopsy and surgery, are now being recognized with increasing frequency with the widespread use of echocardiography. Because of their embolic potential, an aggressive treatment approach is generally accepted. We report a papillary fibroelastoma located at the chorda of the anterior mitral leaflet that underwent conservative follow-up for 8 years without any complications. Because most of the cardiac papillary fibroelastoma cases reported are incidental findings, the question of whether symptomless fibroelastomas must be removed or other factors contribute to the embolic nature of the selected cases remains a challenge for the future.- - - - - - - - - - ranking = 2.3804437959021keywords = cardiac (Clic here for more details about this article) |
5/191. Cardiac valvular papillary fibroelastoma: a report of 2 cases.Papillary fibroelastomas are rare cardiac valve tumors with potential for life-threatening complications such as stroke or sudden death. We report 2 cases of papillary fibroelastoma that were found by echocardiography. The 1st tumor arose from the mitral valve in a patient who presented after multiple transient neurologic events. The 2nd tumor arose from the aortic valve and was found incidentally during coronary artery bypass grafting. Both patients underwent successful surgical removal of the tumor.- - - - - - - - - - ranking = 0.52391124081959keywords = cardiac, sudden death, sudden, death (Clic here for more details about this article) |
6/191. Cardiopulmonary auscultation: duo for strings--Opus 99.In spite of increasing mechanization in medicine and reliance on "high-tech" diagnostic tools, bedside clinical skills of the attending physician can still identify findings that are missed by the more sophisticated devices. Using a stethoscope, we relied on our skills in inspection, palpation, percussion, auscultation, as well as echocardiography and phonocardiography to diagnose a patient whose murmur was very reminiscent of the D-sharp pizzicato in the Cello Sonata in F, Opus 99, by Johannes Brahms. Initial echocardiography was not helpful. We suspected an anomalous chorda and confirmed this with phonocardiography and a second echocardiography. Although advances in cardiac imaging are extremely helpful, the use of simple clinical skills, in addition to being fun, is not obsolete. Cardiopulmonary auscultation should receive more emphasis in the medical school curriculum and clinical training.- - - - - - - - - - ranking = 0.47608875918041keywords = cardiac (Clic here for more details about this article) |
7/191. pathology of the heart and conduction system in a case of sudden death due to a cardiac fibroma in a 6-month-old child.A 6-month-old female infant considered to be in good health died suddenly and unexpectedly. Post-mortem examination was requested, with clinical diagnosis of sudden infant death syndrome. Gross examination revealed, however, the presence of a cardiac mass 4.5 X 4 x 3.5 cm in diameter. Histological examination of the heart confirmed the presence of a cardiac fibroma. In the present case, the sudden death could have been due to the left ventricular outflow obstruction, as much as to conductive disturbances caused by overstretching and compression of the atrioventricular node and of the bundle branches. Hemodynamic and conductive abnormalities are presumed to have provoked bradycardia degenerating into ventricular fibrillation and sudden death. Necroscopy studies of sudden death should always include histological examination of the cardiac conduction system but seldom do.- - - - - - - - - - ranking = 3.6908213091328keywords = cardiac, sudden death, sudden, death (Clic here for more details about this article) |
8/191. Tumors of the cardiac valves: imaging findings in magnetic resonance imaging, electron beam computed tomography, and echocardiography.We describe the findings from various cross-sectional imaging modalities in patients with cardiac valve adherent masses. The techniques are discussed, and imaging findings are compared with the results of cardiac surgery. All three patients had neurological symptoms and/or cardiac murmurs. Transthoracic and/or transesophageal echocardiography revealed the cardiac mass in all three. For differentiation of thrombus and cardiac neoplasm magnetic resonance imaging (MRI) was also performed in all three patients and electron-beam computed tomography (EBCT) in two. Fast segmented cine gradient-echo MRI techniques provided mass depiction in all patients, while T1-weighted spin-echo imaging failed in mass detection in one patient. None of the patients showed evidence of valve regurgitation or stenosis in flow sensitive cine MRI. EBCT excluded mass calcifications in both patients and reliably demonstrated the valve attached lesions. Although echocardiography is the modality of choice in evaluating cardiac masses and especially valve attached masses, MRI and EBCT provide additional information about tissue characteristics and allows an excellent overview of the cardiac and paracardiac morphology. Fast segmented cine gradient-echo MRI is especially able to depict even small tumors attached to rapidly moving cardiac valves, and valve competence can be easily assessed within the same examination.- - - - - - - - - - ranking = 6.1891538693454keywords = cardiac (Clic here for more details about this article) |
9/191. Right ventricular outflow tract obstruction in an older woman: facilitated diagnosis with transesophageal echocardiography-guided biopsy.fibrosarcoma is a rare primary cardiac malignancy. We report the case of a 70-year-old woman who had signs of right ventricular outflow tract obstruction caused by a fibrosarcoma. The pivotal role of multiplanar transesophageal echocardiography in characterizing masses in this location and in guiding transvenous biopsy is discussed.- - - - - - - - - - ranking = 0.47608875918041keywords = cardiac (Clic here for more details about this article) |
10/191. cyanosis caused by a huge obstructive right ventricular fibroma.Cardiac fibromas are rare lesions which occur more often in infants and children than in adults. These tumors are benign proliferations of connective tissue most often found in the left ventricular myocardium or septum. In an 8-month-old infant with cyanosis and progressive exertional dyspnea, a huge cardiac tumor obstructing the right ventricular outflow tract (RVOT) was diagnosed by means of 2-dimensional echocardiography and cardiac catheterization. At surgery, a whitish gray solitary tumor measuring 5.0 x 4.5 cm could be well visualized. It was nearly totally resected, and the RVOT was reconstructed with an Equine pericardial patch. Histologic examination classified the tumor as a fibroma. Although surgical mortality in cardiac fibroma with RVOT obstruction is extremely high, early diagnosis and prompt excision of the tumor is mandatory in relieving its dangerous symptoms.- - - - - - - - - - ranking = 1.4282662775412keywords = cardiac (Clic here for more details about this article) |
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