1/123. Cross-sectional echocardiographic demonstration of duct-related intimal tissue plaques within the pulmonary artery.The cross-sectional and colour flow mapping echocardiographic appearances of extension of ductal tissue within the pulmonary artery in three infants referred for echocardiographic assessment of a cardiac murmur are reported. The ductal plaques described may be common but are not necessarily of clinical significance.- - - - - - - - - - ranking = 1keywords = cardiac (Clic here for more details about this article) |
2/123. Extrauterine pelvic arteriovenous malformation mimicking the clinical presentation of structural heart disease.A case is reported of an extrauterine pelvic arteriovenous malformation involving branches of the internal iliac arteries. cardiomegaly and a rough cardiac murmur were the clinical presentations mimicking a structural heart disease. A continuous bruit could only be detected by the diaphragm of the stethoscope applied firmly to the left lower abdomen. Multiple blood samplings from inferior vena cava, and iliac and femoral veins for determination of oxygen saturation may be necessary for suspected cases. However, selective arteriography remains the best method for diagnosing the presence, extent, and multiplicity of the lesions before surgery or percutaneous arterial embolization.- - - - - - - - - - ranking = 198.64575494864keywords = heart, cardiac (Clic here for more details about this article) |
3/123. Dynamic left ventricular outflow tract obstruction in acute coronary syndromes: an important cause of new systolic murmur and cardiogenic shock.Dynamic left ventricular outflow tract (LVOT) obstruction has traditionally been associated with hypertrophic obstructive cardiomyopathy. Recently, acute dynamic LVOT obstruction has been described as a complication of myocardial infarction (MI). Herein the cases of 3 patients are described, all of whom presented with a systolic murmur and electrocardiographic evidence of MI. All 3 patients developed cardiogenic shock and were subsequently found by echocardiography to manifest an acute dynamic LVOT obstruction. Cardiogenic shock persisted until therapy was directed toward decreasing the degree of the dynamic LVOT obstruction. The treatment of acute coronary syndromes in the presence of a dynamic LVOT obstruction differs from the traditional treatment of acute coronary syndromes and includes the use of beta-blockers and alpha1-agonists, as well as the avoidance of therapies that aggravate the magnitude of the LVOT obstructive gradient, including nitrates, inotropic agents, and afterload reduction. The development of a systolic murmur in the setting of acute MI complicated by cardiogenic shock with only a small elevation in creatine kinase suggests the presence of a dynamic LVOT obstruction, as well as the classical mechanical complications of MI, namely, ventricular septal rupture and papillary muscle rupture. The presence of a dynamic LVOT obstruction is reliably detected by transthoracic echocardiography or by transesophageal echocardiography if transthoracic image quality is suboptimal.- - - - - - - - - - ranking = 0.58905483577798keywords = rupture (Clic here for more details about this article) |
4/123. A 72 year old woman with ALCAPA.ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery), which causes the left coronary artery to grow with an anomalous origin from the pulmonary artery, is a rare disease which may result in myocardial infarction, congestive heart failure, and sometimes death during the early infantile period. A 72 year old woman with ALCAPA syndrome is presented. The asymptomatic patient presented with a cardiac murmur which was discovered during a routine check up for a gynaecological intervention. Coronary cineangiography established the diagnosis. Although surgical correction is the usual treatment for such cases, medical treatment was preferred for this patient because she was asymptomatic without clinical signs of heart failure.- - - - - - - - - - ranking = 80.058301979457keywords = heart, cardiac (Clic here for more details about this article) |
5/123. 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 = 1keywords = cardiac (Clic here for more details about this article) |
6/123. saphenous vein graft from aorta to coronary vein with production of continuous murmur. A complication of coronary artery bypass surgery.A saphenous vein graft was inadvertently placed from the aorta to the coronary vein adjacent to the proximal left anterior descending coronary artery in a 53-year-old man with symptomatic coronary artery disease. The post-operative finding of a continuous murmur led to cardiac catheterization and successful surgical correction. The postoperative finding of a continuous murmur must alert the clinician to this possible technical error.- - - - - - - - - - ranking = 1keywords = cardiac (Clic here for more details about this article) |
7/123. Failure of medicine: evolution of an atrial septal defect to an Eisenmenger syndrome.The atrial septal defect (ASD) is the most commonly diagnosed congenital defect in adults and has a prevalence of 7.5% of all congenital cardiac anomalies. Less invasive imaging techniques, especially transthoracic and transoesophageal echocardiography, provide more accurate diagnostics, resulting in earlier diagnosis and treatment. Despite these opportunities in high-tech countries, medicine may still fail in detecting initially correctable cardiac anomalies. We present a case of 41-year-old woman with an abnormal murmur at childhood that disappeared with time due to the development of an Eisenmenger syndrome. The importance of a complete haemodynamic evaluation in this patient is illustrated.- - - - - - - - - - ranking = 2keywords = cardiac (Clic here for more details about this article) |
8/123. Mid-systolic click, late systolic murmur syndrome associated with complete heart block.A 60 year old woman is presented who had the mid-systolic click, late systolic murmur syndrome, documented by phonocardiogram and left ventricular angiography. During an episode of non-anginal chest pain, advanced heart block was demonstrated and permanent transvenous pacemaker therapy was subsequently instituted. The association of the mid-systolic click, late systolic murmur syndrome and heart block is reviewed. It is suggested that 24-hour continuous electrocardiographic monitoring, as well as exercise stress testing, be included in the evaluation of patients with this syndrome.- - - - - - - - - - ranking = 237.17490593837keywords = heart (Clic here for more details about this article) |
9/123. An uncommon echocardiographic marker for anomalous origin of the left coronary artery from the pulmonary artery: visualization of intercoronary collaterals within the ventricular septum.A rare and striking echocardiographic finding with color-flow Doppler--visualization of intercoronary collaterals within the ventricular septum--in an asymptomatic 5-year-old girl is reported. It strongly suggests anomalous origin of the left coronary artery from the pulmonary artery. Several additional echocardiographic features can secure the diagnosis and allow one to proceed with surgical correction without confirmatory cardiac catheterization and angiocardiography. The ages of our patient and of the seven cases reported previously suggest that these collaterals will more likely be identified beyond infancy and in relatively asymptomatic patients with this congenital anomaly.- - - - - - - - - - ranking = 1keywords = cardiac (Clic here for more details about this article) |
10/123. Echocardiographic manifestations of postinfarction ventricular septal rupture.The echocardiographic features of three patients with postinfarction ventricular spectal rupture are described. All patients showed a decreased or paradoxical motion on the ventricular septum, and two of the patients demonstrated an unusual motion of the tricuspid valve. There were no abnormalities in mitral valve motion. The echocardiogram can be helpful in the diagnosis of postinfarction ventricular septal rupture and can assist in distinguishing this condition from acute disruption of the mitral valve complex.- - - - - - - - - - ranking = 1.7671645073339keywords = rupture (Clic here for more details about this article) |
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