Cases reported "Cardiomegaly"

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1/27. Persistent atrial standstill, report of three cases.

    Three cases, of which two are brothers, of persistent atrial standstill are reported. The diagnosis was made by the lack of P wave in routine 12 leads and right atrial cavity lead, no response of atrium to electrical stimulation and absence of "a" wave in right atrial pressure curve.
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2/27. Cardiac involvement in the Kugelbert-Welander syndrome.

    Two cases of the Kugelberg-Welander syndrome (juvenile form of progressive spinal muscular atrophy) associated with cardiomyopathy and cardiomegaly are presented. The first patient, a 24 year old man, had atrial flutter with complete atrioventricular (A-V) block due to A-H block. echocardiography revealed an increase in the left atrial and right ventricular dimensions. The second patient was a 26 year old man whose electrocardiogram revealed an A-V junctional rhythm, deep Q wave in leads I, aVL and V5 to V6 and an RS pattern in lead V1. Histologic examination of the myocardium in Case 2 showed slight interstitial fibrosis. review of previously reported cases shows that (1) the atrium, the ventricular myocardium and A-V conducting tissue may be involved, and (2) atrial arrhythmias, A-V conduction disturbances and congestive heart failure may occur in the Kugelberg-Welander syndrome.
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3/27. Post-mortem observations of a recent radiofrequency catheter ablation site.

    The acute and chronic gross and microscopic morphologic changes present in myocardium after radiofrequency catheter ablation have been previously described in animal experiments. Acute changes have also been described in four cadaveric human specimens. We describe post-mortem observations of a recent radiofrequency catheter ablation site in a patient who underwent successful ablation for refractory ventricular tachycardia. Our gross and microscopic observations are similar to those previously described in animal experiments and confirm that the animal experimental results can be extrapolated to human hearts. As the use of radiofrequency becomes more prevalent as an alternative treatment for refractory cardiac tachycardias, pathologists will be called upon to identify post-mortem the lesions described. These lesions can be specifically identified, which can serve as a useful verification for this procedure.
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4/27. Postoperative aneurysms of the heart. Case report and review of the literature.

    A postoperative left ventricular pseudoaneurysm is reported in a seven-year-old after closure of an atrial septal defect and repair of partial anomalous venous drainage. A discussion of the etiology and clinical presentation of post operative aneurysms are presented. Cardiac aneurysms of both the true and false variety have been commonly reported following myocardial infarction, blunt and penetrating trauma and infectious processes such as tuberculosis and syphilis. As the frequency of open heart correction of congenital and acquired lesions increases, the incidence of post-operative pseudoaneurysm of heart can also be expected to increase. The diagnosis of this entity in the postoperative period is often difficult and may lead to delay in detection and correction. The clinical presentation and subsequent course of false anurysm differs from the more common true aneurysm to an extent which should be recognized by both cardiologists and cardiac surgeons. A case of left ventricular pseudoaneurysm after open heart repair of an atrial septal defect is reported and a clinical profile which may be helpful in the earlier recognition of this entity is presented.
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keywords = frequency
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5/27. Echocardiographic correlate of presystolic pulmonary ejection sound in congenital valvular pulmonic stenosis.

    A presystolic ejection click was present in a patient with congenital valvular pulmonic stenosis. The coincidence of this sound with presystolic pulmonary valve opening was demonstrated by simultaneous phonoechocardiography. Hemodynamic confirmation of this observation was made by demonstrating presystolic crossover of RV-PA pressures. This sound was distinguished on phonocardiogram as a high frequency sound separate from a lower frequency presystolic (S4) gallop.
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6/27. Severe mitral regurgitation with a normal-sized left atrium.

    The syndrome of severe mitral regurgitation with a normal-sized left atrium may or may not be associated with pulmonary hypertension and prominent left atrial V waves. To explain these pressure alterations by a single pressure-volume relationship is probably not adequate. It would appear that, whatever the clinical circumstances, normal pulmonary vascular pressures cannot exclude the diagnosis of mitral regurgitation.
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7/27. Electrocardiographic changes in scrub typhus patients.

    Ninety-eight cases of scrub typhus were examined electrocardiographically. Various findings beyond the normal range were as follows: In the febrile stage, sinus arrhythmia with some beats below 60 per minute, flat or low T waves in the left precordial leads, sinus tachycardia, ST segment elevation of 4-l mm in V2, prominent u waves measuring 1 mm or more in amplitude, tall and peaked T waves in V2-4, incomplete right bundle branch block, T wave inversion in V3-4, first degree A-V block, Q-Tc interval prolongation, notched T waves in V3, AV junctional escapes, prominent Ta waves or depression of PR segments in V2, and right axis deviation; in the convalescent stage, sinus arrhythmia with some beats below 60 per minute, prominent u waves measuring 1 mm or more in amplitude, tall and peaked T waves in V2-4, flat or low T waves in the left precordial leads, incomplete right bundle branch block, sinus tachycardia, first degree A-V block, Q-Tc interval prolongation, T wave inversion in V3-4, ST segment elevation of 4 mm in amplitude in V2, ventricular premature contractions, atrial premature contractions, and right axis deviation. In comparison with the electrocardiographic findings in 101 asymptomatic normal subjects, flat T waves in the precordial leads, tall and peaked T waves in V2-4 in both acute and convalescent stages, and sinus arrhythmia with some beats below 60 per minute in the convalescent stage were more frequent in cases. Electrocardiographic abnormalities were present most commonly in the acute illness, and our findings support the impression that, with few exceptions, prompt treatment of scrub typhus with antibiotics prevents the serious cardiac complications seen prior to the antibiotic era.
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8/27. Mimics of coronary heart disease.

    Numerous disorders can mimic chronic coronary disease either clinically or electrocardiographically. Particularly noteworthy are wolff-parkinson-white syndrome, asymmetric septal hypertrophy, floppy mitral valve syndrome, angina pectoris with normal coronary arteries, hyperventilation syndrome, neurogenic T wave abnormalities, vasoregulatory abnormality, cervicoprecordial angina, hyperkalemia or hypokalemia, left ventricular hypertrophy, and left anterior fascicular block.
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9/27. Disproportionate hypertrophy of the interventricular septum and its regression in Cushing's syndrome. Report of three cases.

    Three patients of Cushing's syndrome with severe disproportionate hypertrophy of the interventricular septum are reported. All three underwent adrenalectomy and the diagnosis of Cushing's syndrome was confirmed by the presence of adrenal adenoma. All three showed hypertension before the adrenalectomy and two remained hypertensive following adrenalectomy. Before the operations the electrocardiograms revealed inverted T waves in broad leads, and mechanocardiogram systolic and diastolic dysfunction. After the adrenalectomies, abnormal findings on electrocardiograms were normalized and septal hypertrophy was completely regressed. It appears that not only high aortic pressure but also excessive plasma cortisol may be an etiologic factor of the left ventricular hypertrophy in Cushing's syndrome.
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10/27. Flutter and fibrillation-like phenomenon of His bundle observed in a patient with persistent atrial standstill.

    A diagnosis of persistent atrial standstill was made in a patient with syncopal attacks, based on: (1) the lack of P waves both in the routine 12-lead electrocardiogram (ECG) and in the right atrial cavity lead; (2) the absence of "a waves in the right atrial pressure curve; and (3) the failure of the atria to respond to electrical stimulation. Compared with previously reported cases of persistent atrial standstill with a slow, regular escape rhythm of supraventricular origin, the present case was characterized by alternate periods of bradycardia and tachycardia, the latter being suggested as AV junctional tachycardia with exit block. Furthermore, the His bundle electrogram (HBE) showed either regular, high frequency deflictions or irregular, deformed potentials, suggesting flutter and fibrillation-like phenomena in the His bundle.
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keywords = wave, frequency
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