11/83. Cardiac complications in children following infection with varicella zoster virus.infection with varicella zoster virus, leading to chicken pox in susceptible hosts, is usually a benign self-limiting disease conferring immunity in those affected. Cardiac complications are rare, but when present may lead to severe morbidity or mortality. We have recently encountered three children, all of whom developed significant cardiac complications secondary to infection with varicella. myocarditis has long been associated with such infection. The pathological mechanism is presumed similar to other cardiotropic viruses, where both direct cytopathic and secondary auto-immune effects contribute to myocardial cellular destruction and ventricular dysfunction. Complications include arrhythmias and progression to dilated cardiomyopathy. pericarditis, and secondary pericardial effusion, related to infection with the virus is most commonly associated with secondary bacterial infiltration. Both cardiac tamponade and chronic pericardial constriction may result. endocarditis complicating varicella has only been described in the last fifteen years, and is associated with the emergence of virulent strains of both streptococcus and staphylococcus, the two organisms most commonly associated with endocarditis. The exact mechanism by which varicella causes secondary bacterial endocarditis remains unclear. Whilst cardiac complications of infection with the varicella zoster virus are rare, the resulting complications are potentially life threatening. Evidence of varicella-induced carditis must be aggressively pursued in any child with signs of acute cardiac decompensation in whom chicken pox is confirmed or suspected.- - - - - - - - - - ranking = 1keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
12/83. Mitral insufficiency secondary to coronary heart disease.Twenty-four patients were operated on for mitral regurgitation secondary to coronary heart disease. Their common features consisted of a history of myocardial infarction, congestive heart failure, coronary occlusive disease, left ventricular dysfunction, low cardiac output, pulmonary hypertension, and increased left ventricular end-diastolic pressure. Fourteen patients were in intractable congestive heart failure at the time of operation. The operative procedures employed consisted of aneurysmectomy in 4 patients; mitral valve replacement (MVR) in 7;MVR and revascularization in 4; MVR and aneurysmectomy in 5;MVR, revascularization, and partial ventricular resection in 3; and MVR with closure of ventricular septal perforation in 1 patient. Six patients died, a hospital mortality of 25%, and only 42% had good results. The degree of associated coronary artery disease and the status of the left ventricular myocardium were the most important prognostic factors.- - - - - - - - - - ranking = 1.670658773199keywords = ventricular dysfunction, left ventricular dysfunction, dysfunction (Clic here for more details about this article) |
13/83. Clinically and histologically silent q fever endocarditis accidentally diagnosed by PCR.A case of q fever endocarditis was diagnosed in a patient with no sign of active endocarditis by performing PCR targeting eubacterial 16S rDNA on the resected mitral valve. The diagnosis was confirmed by detection of high levels of anti-coxiella burnetti antibodies, positive immunohistologic analysis of the valve tissue with specific antibodies and culture of C. burnetti from the valve tissue. As this patient had an unexplained aggravation of valve dysfunction, we recommended routine serologic testing for C. burnetti to allow the diagnosis of q fever endocarditis at a very early stage.- - - - - - - - - - ranking = 0.0120430729793keywords = dysfunction (Clic here for more details about this article) |
14/83. Transmitral endoventricular repair of left ventricular pseudoaneurysm following mitral valve replacement.Left ventricular (LV) pseudoaneurysm is a rare but serious complication of mitral valve replacement and is usually the consequence of atrioventricular separation. Although there may be a role for nonoperative treatment in the presence of a small false aneurysm and in the absence of paravalvular leak, the presence of a large false aneurysm usually mandates surgical intervention. This may be hazardous in patients with concomitant LV dysfunction. We report a case of a patient who presented with a large LV pseudoaneurysm following numerous attempts of mitral valve replacements for a variety of reasons, including endocarditis. Some of the technical details of aneurysm repair and aspects of myocardial protection are discussed. In our patient, avoidance of cardioplegic arrest may have contributed to the successful outcome.- - - - - - - - - - ranking = 0.0120430729793keywords = dysfunction (Clic here for more details about this article) |
15/83. ventricular dysfunction in a patient with Plummer's disease: a case report.A 76-year-old female patient complained of intermittent palpitation, shortness of breath, and orthopnea for 10 days. The patient was found to have cardiomegaly, left ventricular dilatation secondary to moderate regurgitation, with impaired ventricular dysfunction and persistent sinus tachycardia. The patient also had a nodular goiter with increased uptake on radionuclide scan on the right side of the thyroid gland, low serum thyroid-stimulating hormone, with normal triiodothyronine, and free thyroxine. Plummer's disease with ventricular dysfunction was diagnosed. We present this rare case and a review of the literature.- - - - - - - - - - ranking = 2.0481722919172keywords = ventricular dysfunction, dysfunction (Clic here for more details about this article) |
16/83. Triple valve replacement in a patient with severe carcinoid heart disease.We report on the case of a 34-year-old male patient suffering from end-stage carcinoid heart disease with severe tricuspid, pulmonary and mitral valve regurgitation. In addition, a persisting foramen ovale was present. The primary carcinoid tumor was never discovered. However, urine 5-hydroxy-indole-acetic-acid (5-HIAA) were consistently elevated after the first diagnosis of carcinoid disease and after eight years of medication with octreotide and Interferon alpha-2b our patient developed significant cardiac insufficiency mainly due to severe valvular dysfunction. Ultimately, mechanical tricuspid, mitral and pulmonary valve replacement was performed. Twelve hours following the operation the patient had to be returned to the operating room for persisting intrathoracic hemorrhage. He recovered uneventfully and was discharged from hospital on day 37. Twelve months following triple valve replacement the cardiac status recovered from preoperative NYHA-IV to NYHA-I.- - - - - - - - - - ranking = 0.0120430729793keywords = dysfunction (Clic here for more details about this article) |
17/83. diagnosis of prosthetic mitral valve malfunction with combined echo-phonocardiography.Fifty-three patients were studied with combined echo-phonocardiography or phonocardiography alone following prosthetic valve replacement. In sixteen of these patients, clinical deterioration developed, and all subsequently underwent cardiac catheterization and/or surgery. Two patients came to autopsy. Included in this group of sixteen patients were five with obstructed prosthesis, six with paravalvular regurgitation, and five with left ventricular dysfunction. Measurements were made of the time interval from the aortic valve closure sound to the peak opening of the mitral prosthesis determined echocardiographically or to the mitral prosthetic opening click (A2-MVO). Echocardiographic studies of left ventricular wall motion were also performed. The A2-MVO interval was significantly shortened (P less than 0.01) with prosthetic valve obstruction (.05 /- .02 sec) and paravalvular regurgitation (.05 /- .01 sec) compared with normally functioning prostheses (Starr-Edwards ball valves .10 /- .02 sec, Lillehei-Kaster tilting disc prostheses .09 /- .01 sec). Shortening of this interval was not specific for these conditions because it was sometimes shortened with left ventricular dysfunction. Echocardiographic studies of left ventricular wall motion were helpful in distinguishing among prosthetic valve obstruction, paravalvular regurgitation and left ventricular dysfunction. The combined echo-phonocardiographic technique was especially helpful in detecting malfunction of tilting disc prostheses, because the technique enables measurement of the A2-MVO interval in the absence of an audible opening click.- - - - - - - - - - ranking = 5.011976319597keywords = ventricular dysfunction, left ventricular dysfunction, dysfunction (Clic here for more details about this article) |
18/83. Intracardiac thrombosis and mitral prosthesis dysfunction in systemic lupus erythematosus. A case report.Systemic lupus erythematosus (SLE) is an inflammatory disease characterized by deposition of autoantibodies and pathogenic immune complexes in the cells and tissues of an organism, causing lesions. The heart is one of the most frequently involved organs, valvar involvement being common (27%) and of great clinical importance. Some studies suggest that valvar involvement is associated with the presence of a specific autoantibody, the antiphospholipid antibody (aPL). In these circumstances, major complications may occur such as arterial or venous thrombosis, thrombocytopenia, repeated spontaneous abortions and presence of lupus anticoagulant antibody. Among the semiologic methods for cardiac evaluation, echocardiography is the main instrument for investigating the anatomical and functional involvement of the heart in the great majority of systemic diseases like SLE. We report the case of a patient with SLE and aPL syndrome who underwent surgery for mitral valve replacement with a biological prosthesis and died nine months later due to massive intracardiac thrombosis and prosthesis dysfunction.- - - - - - - - - - ranking = 0.060215364896499keywords = dysfunction (Clic here for more details about this article) |
19/83. Successful repair of aortic and mitral incompetence induced by methylsergide maleate: confirmation by intraoperative transesophageal echocardiography.Methylsergide maleate, an effective anti-migraine medication, has a well-documented association with left-sided cardiac valve dysfunction. Prior reports have described cardiac valve dysfunction in patients using methylsergide chronically for a minimum of 6 years, with surgical intervention consisting of valve replacement for patients with intractable congestive heart failure. We report a 51-year-old woman who developed severe mitral and aortic valvular dysfunction after taking methylsergide maleate for migraine headaches for a period of 19 months, and who subsequently underwent aortic and mitral valve repair with excellent short-term results.- - - - - - - - - - ranking = 0.036129218937899keywords = dysfunction (Clic here for more details about this article) |
20/83. SAM-systolic anterior motion of the anterior mitral valve leaflet post-surgical mitral valve repair.Systolic anterior motion (SAM) is a postoperative complication experienced by patients undergoing mitral valve repair. The incidence of SAM after mitral valve repair ranges from 5 to 10%. Early recognition of the signs and symptoms of SAM is imperative to the management of these patients. This article presents the pathophysiology of mitral valve dysfunction to give the practitioner a clear understanding of the dynamics of SAM. This article's main focus is the detection and management of SAM and the most current treatment modalities. A case study is used to illustrate the complex management necessary for the patient with SAM.- - - - - - - - - - ranking = 0.0120430729793keywords = dysfunction (Clic here for more details about this article) |
| <- Previous || Next -> |