Cases reported "Heart Diseases"

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1/176. An unusual family of benign "X" linked muscular dystrophy with cardiac involvement.

    A family of benign X-linked muscular dystrophy is described. Two of the 3 affected members appear quite representative of Becker's dystrophy. A third shows no pseudohypertrophy, only gross atrophy, affecting proximal and distal muscles and also shows early onset contractures and electrocardiographic abnormalities and is in these ways much more representative of the variety described by Emery and Dreifuss (1966). Two of the cases have distinctly abnormal electrocardiograms with extensive and deep Q waves and abnormal R/S ratios and VI. Both these have shown progression of electrocardiographic abnormalities during a 2-year follow-up. The family is reported to document this very unusual occurrence.
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ranking = 1
keywords = deep
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2/176. Successful thrombolysis of right atrial and ventricle thrombi encircling a temporary pacemaker lead in a patient with heparin-induced thrombocytopenia type II.

    Only few reports exist addressing the problem of temporary pacemaker leads associated with thromboembolic disease. We report the case of a 67-year-old patient who required a temporary transfemoral pacemaker due to AV block grade III. The patient developed extensive right atrial and ventricle thrombus formation attached to the pacing wire, as well as venous thrombosis at the insertion site due to heparin-induced thrombocytopenia type II (HIT type II). After short-term thrombolysis with 1 mg rt-PA/kg b.w. complete resolution of all clots could be shown by B-mode sonography and transthoracic, as well as transesophageal echocardiography.
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ranking = 4159.9688647652
keywords = thrombosis, venous thrombosis
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3/176. Thrombolytic treatment of type A right atrial thrombi: description of three cases and review of the literature.

    Type-A right atrial thrombosis is characterized by echocardiographic detection of mobile worm-shaped thromboemboli in the right atrium, with a high propensity to embolic dislocation into the pulmonary circulation. This type of thrombus is associated with a very high mortality rate that exceeds 60% in untreated patients. Surgical embolectomy has been proposed as the treatment of choice, but the availability of an experienced surgical staff and the patients' eligibility for surgical treatment cannot be taken for granted. Efficacy of systemic thrombolysis for treatment of type-A right atrial thrombosis has repeatedly been reported during the past few years, with early mortality rates comparable to those of surgical approach. The major advantages of thrombolysis would be ease of administration and independence of patient's hemodynamic status. Our experience confirms these impressions and argues in favor of the routine use of systemic thrombolysis in the presence of a type-A right atrial thrombus, while reserving surgical embolectomy for patients with formal contraindications to thrombolysis.
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ranking = 8195.9180669583
keywords = thrombosis
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4/176. A successful case of pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension with a thrombus in the right ventricle.

    Chronic thromboembolism is a frequent cause of progressive hypertension and carries a poor prognosis. Medical treatment is not effective and surgery provides the only potential for a cure at present. We herein report a successful case of thromboendarterectomy treated via a median sternotomy with intermittent circulatory arrest. A 43-year-old man was admitted to our hospital complaining of progressive dyspnea, edema of the lower extremities, and a fever with an unknown origin. A subsequent definitive evaluation showed him to be suffering from surgically accessible chronic thromboembolic pulmonary hypertension with a thrombus in the right ventricle. He underwent a pulmonary thromboendarterectomy and thrombectomy via a median sternotomy with intermittent circulatory arrest on November 24, 1994. Postoperatively he showed a marked improvement in his hemodynamic status and blood gas analysis. He has also returned to work with no trouble. Deep vein thrombosis appeared to be the pathogenesis of this case, but we could not find the origin of his unknown fever. He is currently being controlled by treatment with methylprednisolone as before.
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ranking = 4104.7607220395
keywords = thrombosis, vein
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5/176. Atrial thrombosis in cardiac amyloidosis: diagnostic contribution of transesophageal echocardiography.

    Few cases of atrial thrombosis detected by transesophageal echocardiography (TEE) in cardiac amyloidosis have been reported recently. We present the cases of 3 consecutive patients affected by AL-type cardiac amyloidosis, symptomatic for heart failure and in sinus rhythm. All patients had a cardiac restrictive pattern at Doppler examination. TEE showed left atrial thrombus in 2 patients and biatrial thrombi in 1 patient; conventional transthoracic echocardiography detected only 1 left atrial thrombus. Our experience confirms the association between cardiac amyloidosis and atrial thrombosis, even in sinus rhythm. TEE should be considered to assess thromboembolic risk in all cases of cardiac amyloidosis with severe diastolic dysfunction.
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ranking = 24587.754200875
keywords = thrombosis
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6/176. 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.
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ranking = 6.8016885603518
keywords = vein
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7/176. thromboembolism in the right side of the heart.

    Right-sided cardiac thromboemboli, or pulmonary emboli-in-transit, represent an unusual disease process with high morbidity and mortality. We present a detailed case report and a synopsis of our experience at the University of mississippi Medical Center between 1990 and 1997 and review the current medical literature. These thrombi and emboli may largely be subdivided into type A--a mobile, serpiginous clot that is probably a mobilized deep vein thrombus--and type B--a rather immobile clot morphologically similar to left-sided heart thrombi that may represent intracardiac thrombosis. The mainstays of therapy include surgical embolectomy and thrombolysis, but there is no clear benefit of one over the other. Treatment should be individualized according to the clot's size and morphology, likelihood of preexisting pulmonary embolism, the patient's cardiopulmonary reserve, comorbid conditions, and local expertise with treatment modalities.
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ranking = 4105.7607220395
keywords = thrombosis, vein, deep
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8/176. Central venous catheter mechanical irritation of the right atrial free Wall:A cause for thrombus formation.

    thromboembolism is a major complication of long-term central venous catheter, usually associated with catheter or venous occlusion. Intracavitary right atrial thrombosis is currently considered to result from line-tip thrombosis extension. We report three adult patients in whom repeated mechanical trauma to the right atrial wall was probably the main mechanism. Transesophageal echocardiography revealed back and forth movement of the central catheter into a thrombus attached to the right atrial wall, thus suggesting a mechanism of catheter-associated thrombus formation, not previously visualized or suggested. Catheter removal and anticoagulation administration were undertaken with an uneventful clinical course and almost complete disappearance of the thrombi on transesophageal echocardiography follow-up.
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ranking = 8195.9180669583
keywords = thrombosis
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9/176. Repeated thrombolysis in multiple episodes of obstructive thrombosis in prosthetic heart valves: a report of three cases and review of the literature.

    BACKGROUND AND AIM OF THE STUDY: Thrombolysis is an emerging method to open thrombosed prosthetic heart valves. However, its applicability and safety in multiple recurrent thrombotic episodes is unclear. methods: Among 16 patients with thrombosed prosthetic valves treated with thrombolysis during a 33-month period, three patients (one mitral and two tricuspid) experienced four episodes each, and these were treated with repeated thrombolytic therapy. Data on patient demographics, clinical presentation, diagnosis, treatment and outcome are presented. RESULTS: Thrombolysis was successful in 10/12 episodes (83%); there was delayed response in one episode (8%), and partial response in one episode (8%). There were no major complications. However, a fifth thrombotic episode occurred in two patients with tricuspid prostheses, mandating re-do surgery. CONCLUSION: Thrombolysis in re-thrombosed prosthetic heart valves is feasible, highly successful and safe, and may therefore be used judiciously in selected patients who could not, or would not, undergo redo surgery. A high recurrence rate in the tricuspid position may implicate earlier surgical intervention, which should be individualized.
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ranking = 16391.836133917
keywords = thrombosis
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10/176. Intermittent electromechanical dissociation as an unusual sign of prosthetic valve thrombosis in a patient with prosthetic fibrous ingrowth.

    We describe the echocardiographic features of an unusual hemodynamic phenomenon of intermittent electromechanical dissociation during regular sinus tachycardia in a patient with prosthetic mitral valve thrombosis. Thrombolysis with a solution of recombinant tissue-type plasminogen activator resulted in the disappearance of electromechanical dissociation and was effective in stabilizing the patient's condition. The later discovery of panus covering the valve ring after the lysis of clots confirmed surgery as the definitive treatment.
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ranking = 20489.795167396
keywords = thrombosis
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