- Pulmonary embolectomy in a case of subacute pulmonary embolism, with previous unsuccessful fibrinolysis [Journal Article]
- RMRev Med Inst Mex Seguro Soc 2018 11 30; 56(4):418-423
- CONCLUSIONS: Surgical pulmonary embolectomy rescue is an alternative management with highly satisfactory results.
- A surgical case of aortic stenosis with recurrent gastrointestinal bleeding: Heyde syndrome. [Journal Article]
- IJInt J Surg Case Rep 2018 Nov 10; 53:281-284
- CONCLUSIONS: Heyde syndrome is associated with acquired von Willebrand disease type IIA and AS. The true characteristic of von Willebrand disease type IIA is hemorrhagic diathesis caused by deficiency of high-molecular-weight multimers of vWF. Under the influence of high shear stress caused by AS, vWF is stretched and easily cleaved by vWF-cleaving protease. Consequently, it causes deficiency of high-molecular-weight multimers of vWF and primary hemostasis impairment. Therefore, the most effective treatment for Heyde syndrome is correction of AS. AVR can improve not only the hemodynamic status but also coagulopathy.The differential diagnosis of patients with recurrent GI bleeding with concurrent systolic murmur should include Heyde syndrome.
- Ruptured mitral valves chordae tendineae around a convalescent infant with acute Kawasaki disease. [Journal Article]
- CYCardiol Young 2018 Oct 26; :1-6
- Severe valvulitis owing to acute Kawasaki disease leading to severe mitral regurgitation is a rare event in infants. Further, there is less information about underlying ruptured mitral chordae tendin...
Severe valvulitis owing to acute Kawasaki disease leading to severe mitral regurgitation is a rare event in infants. Further, there is less information about underlying ruptured mitral chordae tendineae causing severe mitral regurgitation. We encountered ruptured mitral chordae tendineae in three female patients after Kawasaki disease. The age at the onset of Kawasaki disease ranged from 3 to 8 months, and detection of ruptured mitral chordae tendineae was from 24 to 90 days. Two patients had acute heart failure, and one was asymptomatic. One patient underwent mitral annuloplasty, and the others responded to medication. These ruptured mitral chordae tendineae occurred after the remission of the initial acute Kawasaki disease, in the early course and the convalescent of acute Kawasaki disease. Further, the recurrent fever was also detected in them. The ruptured mitral chordae tendineae in an infant within 6 months can be detected by systolic heart murmur around the convalescent stage of acute Kawasaki disease, although the prevalence is very low.
- Infective Endocarditis, a Rare Complication of Late Neonatal Group B Strep Sepsis. [Journal Article]
- FPFront Pediatr 2018; 6:274
- Background: Infective endocarditis (IE) is extremely rare in infants with structurally normal hearts. We present a case of Group B Streptococcus (GBS) endocarditis in a 5 week old. Clinical Case: A ...
Background: Infective endocarditis (IE) is extremely rare in infants with structurally normal hearts. We present a case of Group B Streptococcus (GBS) endocarditis in a 5 week old. Clinical Case: A 5-week old male presented to his local hospital with fever and was diagnosed with GBS sepsis. He received 4 days of intravenous antibiotics and was discharged home with 6 days of oral antibiotics. He re-presented 5 days after discharge with severe sepsis as well as a new pathological pan systolic murmur and was diagnosed with IE following echocardiographic identification of a mitral valve vegetation. He was subsequently transferred to a tertiary cardiology center. Ten days after readmission he developed an intracranial hemorrhage associated with rupture of a mycotic aneurysm requiring emergency evacuation. Conclusion: Late-onset GBS sepsis is rare, but when improperly treated can have severe consequences. Infant IE is extremely rare. When diagnosed prompt treatment must be initiated to provide the best outcome for the patient, including consideration of surgical removal of the vegetation.
- A male with multiple cardiac masses [Journal Article]
- EREcho Res Pract 2018 Sep 01; 5(3):K53-K58
- Thirty-seven-year-old male presented with cough, dyspnea, significant weight loss (20 kg) and subacute fever for the past 2 months. Physical examination revealed inspiratory and expiratory wheezing b...
Thirty-seven-year-old male presented with cough, dyspnea, significant weight loss (20 kg) and subacute fever for the past 2 months. Physical examination revealed inspiratory and expiratory wheezing bilaterally. A normal S1, S2 and a 3/6 systolic ejection murmur at the left upper parasternal border with respiratory variation were found during cardiac auscultation. Kidney and bone marrow biopsy reported a high-grade B-cell lymphoma. Echocardiography and cardiac CT findings consisted of multiple intracardiac masses affecting the right ventricular (RV) outflow track, RV apex, medial portion of the right atrium and posterior left atrium, as well as mild impairment of the RV systolic function. The masses in the RV outflow track caused partial obstruction (pulmonary valve peak velocity 2.3 m/s) with a RV systolic pressure of 43 mmHg. The infiltrative mass in the interatrial septum extended into both the right and left atrial cavities. The right superior pulmonary vein was occluded. This patient was treated with aggressive chemotherapy and had a good clinical response that resulted in mass size reduction after the first course of chemotherapy. Multimodality imaging techniques such as echocardiography, cardiac CT and PET scan can provide complementary information to better evaluate, stage and manage these patients.
- Accessory and solitary main papillary muscle hypertrophy resulting in dynamic mid-left ventricular obstruction: Contribution of multimodality imaging in highlighting of dynamic and structural abnormalities. [Journal Article]
- JCJ Cardiol Cases 2018; 18(3):113-117
- Solitary main and/or accessory papillary muscle (PM) hypertrophy may be an uncommon type of hypertrophic cardiomyopathy that does not meet all the usual criteria. The dynamic intraventricular obstruc...
Solitary main and/or accessory papillary muscle (PM) hypertrophy may be an uncommon type of hypertrophic cardiomyopathy that does not meet all the usual criteria. The dynamic intraventricular obstruction related to this PM hypertrophy can be deleterious with an important clinical impact on patients. The mechanisms of such obstruction attracted a lot of attention in order to propose an appropriate treatment. We report a case of a 36-year-old man presenting with a chief complaint of progressively worsening exertional dyspnea. He had demonstrated labile systolic murmur for more than 3 years. Rest echocardiography revealed coexistence of a solitary main PM hypertrophy and additional accessory PM with no left ventricular outflow tract or mid ventricle obstructions. The patient underwent exercise stress echocardiography unmasking severe mid-ventricle obstruction (peak systolic gradient at exercise of 100 mmHg). There was no obvious parietal hypertrophy elsewhere. Cardiac magnetic resonance imaging provided us with anatomical arguments that could explain the dynamic process of obstruction. In fact, multimodality imaging has a determinant role in the screening of spatial configuration and structural abnormalities of PMs in order to avoid the misinterpreting of some atypical presentations of hypertrophic cardiomyopathy. <Learning objective: Solitary main and/or accessory papillary muscle (PM) hypertrophy is an uncommon type of hypertrophic cardiomyopathy: hypertrophy concerns only the PM and spares the other parietal left ventricle segments. Multimodality imaging has a crucial role in the characterization of PM morphology and their incrimination in the pathological process of dynamic obstruction. Surgical treatment depends on the concerned PM, its extent to the mitral leaflet or the septum, or both, and the severity of hypertrophy.>.
- Nature's balancing act: Infective endocarditis of pulmonary valve with ventricular septal defect in fifth decade; a rare and unusual presentation. [Journal Article]
- JCJ Cardiol Cases 2018; 17(3):77-79
- It is unusual for a moderate-size ventricular septal defect (VSD) to remain asymptomatic and complication-free until the age of 45 years. Similarly, infective endocarditis of anatomically normal pulm...
It is unusual for a moderate-size ventricular septal defect (VSD) to remain asymptomatic and complication-free until the age of 45 years. Similarly, infective endocarditis of anatomically normal pulmonary valve is also rare. Here we report a case in which nature created a protection for VSD, i.e. right ventricular outflow tract (RVOT) obstruction, which led to a complication, i.e. pulmonary valve endocarditis. A 45-year-old sick-looking man presented in medical emergency with fever and progressively increasing breathlessness for the previous 2 weeks. He had no significant past history. The patient was febrile and on cardiovascular (CVS) examination, ejection systolic murmur in left upper parasternal region was heard, suggesting a diagnosis of infective endocarditis. Echocardiography revealed subaortic VSD of 1.2 cm size with left to right shunt. There was moderator band hypertrophy in sub-infundibular right ventricle (RVOT obstruction) creating obstruction to blood flow, thus preventing development of pulmonary artery hypertension. There were two large vegetations (4 × 3 mm) on each leaflet of pulmonary valve. High speed turbulent jet of blood generated from right ventricle obstruction was striking the pulmonary valve leaflets which led to injury and subsequent development of infective endocarditis of pulmonary valve. The patient improved on intravenous antibiotics. The plan was to give 6 weeks of antibiotics followed by surgical closure of VSD and resection of moderator band. <Learning objective: It is rare for a moderate size ventricular septal defect to remain asymptomatic and complication-free until the age of 45 years. Sometimes nature creates a barrier in the form of moderator band hypertrophy in sub infundibular right ventricle i.e. RVOT obstruction, leading to obstruction to blood flow and preventing development of pulmonary hypertension.>.
- Diagnostic value of vertebral left atrial size as determined from thoracic radiographs for assessment of left atrial size in dogs with myxomatous mitral valve disease. [Journal Article]
- JAJ Am Vet Med Assoc 2018 Oct 15; 253(8):1038-1045
- CONCLUSIONS: AND CLINICAL RELEVANCE Results indicated VLAS was a repeatable and useful radiographic measurement for prediction of LA enlargement in dogs with MMVD.
- Unusual case of primary pulmonary Hodgkin's lymphoma presenting with a continuous murmur. [Journal Article]
- BCBMJ Case Rep 2018 Sep 28; 2018
- Systemic to pulmonary fistulas are an unusual entity, even more so in association with Hodgkin's lymphoma. We herein report a case of a 33-year-old woman that presented with an incidental lung lesion...
Systemic to pulmonary fistulas are an unusual entity, even more so in association with Hodgkin's lymphoma. We herein report a case of a 33-year-old woman that presented with an incidental lung lesion on a chest radiograph with an associated high-frequency continuous murmur over the lesion. The diagnosis of primary pulmonary Hodgkin's lymphoma, nodular sclerosis type, was obtained by a CT transthoracic biopsy. We achieved an excellent response after polychemotherapy with near-complete disappearance of the mass and a residual faint systolic murmur over the lesion.
New Search Next
- Fourteen-year-old boy with decreased appetite and pedal swelling. [Journal Article]
- HHeart 2018 Sep 21
- CLINICAL INTRODUCTION: A 14-year-old boy presented with history of decreased appetite and bilateral swelling of feet for 6 months. He did not give any associated history of orthopnoea or paroxysmal ...
CLINICAL INTRODUCTION: A 14-year-old boy presented with history of decreased appetite and bilateral swelling of feet for 6 months. He did not give any associated history of orthopnoea or paroxysmal nocturnal dyspnoea. He was born by a normal delivery after a non-consanguineous marriage. He had an unremarkable birth and childhood health history. There was no family history of significant cardiovascular illness or sudden death. Clinical examination showed an average built boy with elevated jugular venous pressure with prominent v wave and bilateral pitting pedal oedema. Cardiovascular examination showed normal first (S1) and second (S2) heart sounds and a short early systolic murmur over tricuspid region. Other systems examination was remarkable for soft tender hepatomegaly.ECG showed sinus rhythm with tall, peaked p waves. Chest X-ray revealed enlargement along the right cardiac border. Transthoracic echocardiographic images are shown in figure 1A (apical four-chamber view) and figure 1B (tricuspid inflow Doppler). There was no colour Doppler evidence of interatrial shunt.