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Cardiac murmur

Ricardo Fonseca, Faraz Pathan, Thomas H Marwick
OBJECTIVE: We sought whether simple clinical markers could be used in a questionnaire for recognition of inappropriate (or rarely appropriate, RA) tests at point-of-service. Most applications of appropriateness criteria (AC) for transthoracic echocardiogram (TTE) have been at the point of order, but a simple means of identifying RA tests in an audit process would be of value. DESIGN, SETTING AND PARTICIPANTS: The study was performed in 2 major hospitals in Tasmania...
October 5, 2016: BMJ Open
C Schwarzwald
Heart murmurs and arrhythmias are common in horses. Assessment of their clinical relevance concerning health, performance, safety and longevity of sports horses is of highest importance. A comprehensive cardiovascular examination is crucial for diagnosis and assessment of the severity of disease. Recently, an expert panel of the American College of Veterinary Internal Medicine (ACVIM) and the European College of Equine Internal Medicine (ECEIM) developed a consensus statement containing recommendations for sports horses with heart disease...
October 2016: Schweizer Archiv Für Tierheilkunde
Valérie Chetboul, Isabelle Pitsch, Renaud Tissier, Vassiliki Gouni, Charlotte Misbach, Emilie Trehiou-Sechi, Amandine M Petit, Cécile Damoiseaux, Jean-Louis Pouchelon, Loïc Desquilbet, Eric Bomassi
OBJECTIVE To characterize the epidemiological, clinical, and echocardiographic features of dogs and cats with tetralogy of Fallot (TOF) and determine their survival times. DESIGN Retrospective case series. ANIMALS 15 dogs and 16 cats with a diagnosis of TOF as determined via echocardiography. PROCEDURES Medical records of dogs and cats were reviewed to extract information on signalment, clinical status at the time of TOF diagnosis, echocardiographic findings, and any outcome data. RESULTS The most common canine breeds were terrier types (n = 7)...
October 15, 2016: Journal of the American Veterinary Medical Association
K Li, F E Zhang, A P Wang, G F Zhu
Objective: To investigate the clinical features, pathogenic distribution and drug susceptibility of patients with infective endocarditis (IE). Methods: Clinical data of IE patients were collected, who were admitted to Capital Medical University Affiliated Beijing Anzhen Hospital from January 2012 to March 2015. Results: Three hundred and three IE patients were enrolled with age of (43±16) years old. Fever (85.5%)and cardiac murmur (62.4%)were the most common clinical presentations. Congenital heart diseases was the leading underlying diseases in IE patients...
October 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Mahmoud A Abdelsalam, Jeffrey B Geske
CLINICAL INTRODUCTION: A 77-year-old female was referred for evaluation of an episode of syncope while eating breakfast. There was no history of fall, syncope, prodrome, dyspnoea, chest discomfort or palpitations. Medical history was notable for hyperlipidaemia and treated hypertension. Blood pressure was 140/90 mm Hg, pulse 85  beats per minute (BPM). No murmurs were present on cardiac examination. ECG revealed normal sinus rhythm with left ventricular (LV) hypertrophy (see online supplementary figure S1)...
September 23, 2016: Heart: Official Journal of the British Cardiac Society
Héctor Ugalde, Diego Ugalde, Gastón Dussaillant
Coronary artery fistulae are abnormal connections between a coronary artery and any cardiac chamber or other vessels. Most of them have a congenital origin. We report a 60 years old woman referring a history of progressive dyspnea and orthopnea during the last year. A continuous heart murmur was audible in the third and fourth intercostal spaces at the left sternal border. Electrocardiogram was normal and echocardiography showed mild dilation of right cavities and an image suggesting a dilated right coronary artery with flow to right atrium...
July 2016: Revista Médica de Chile
Guang Song, Jing Zhang, Weidong Ren, Ying Li, Ke Zhou
BACKGROUND: Coronary artery fistula (CAF) is a rare cardiac anomaly. Application of transthoracic echocardiography (TTE) is not fully illustrated in pediatric period. Meanwhile, the treatment strategy of CAF is still a controversial issue. CASE PRESENTATION: Five cases of CAF with different types were presented. We also retrospectively reviewed 32 records of CAF in our institution from May 2001 to January 2015, including cardiac murmurs, symptoms, TTE diagnoses, complications, other anomalies, treatment and outcome...
2016: SpringerPlus
Tetsuo Yamanaka, Toru Fukatsu, Yoshimaro Ichinohe, Hirotaka Komatsu, Masahiro Seki, Kenichi Sasaki, Hideaki Takai, Takashi Kunihara, Yasunobu Hirata
We herein report an adult case of unicommissural unicuspid aortic valve (UAV). A 59-year-old man, who was noted to have a cardiac murmur at 31 years of age, was admitted to our hospital due to acute heart failure. Severe calcification in the aortic valve with severe low-flow/low-gradient aortic stenosis and moderate aortic regurgitation was observed and thought to be the cause of heart failure, however, the etiology of aortic valve dysfunction was not clear. Aortic valve replacement was subsequently performed, and unicommissural UAV was diagnosed according to the intraoperative findings...
2016: Internal Medicine
Brian Raffetto, Neil Rifenbark, Ashokkumar Jain
BACKGROUND: Traumatic axilloaxillary arteriovenous (AV) fistulas are rare occurrences, with the predominance of AV fistulas in this region occurring as an alternative surgical intervention in patients who are undergoing hemodialysis. CASE REPORT: We describe the case of a young man with this condition caused by a previous penetrating trauma who had a delayed diagnosis primarily because of the infrequency of the clinical presentation. This is one of a few documented cases of axilloaxillary AV fistulas in the setting of trauma...
September 6, 2016: Journal of Emergency Medicine
James Jones, Robert Liotta, Maureen Hood, Alexander Bustamante
We report a case of a 35-year-old active duty male with a rare quadricuspid aortic valve identified via transthoracic echocardiography following the detection of an incidental grade I/VI diastolic murmur. Further characterization of the anatomical findings and aortic valve flow dynamics were evaluated with cardiac magnetic resonance imaging. Accurate assessment of the various valve morphologies is essential, as it guides surgical treatment options to correct the defect. Our case highlights the complimentary role of cardiac magnetic resonance imaging in defining the anatomy and functional consequences of a quadricuspid aortic valve...
September 2016: Military Medicine
Junichi Miyamoto, Kyo Niijima
An intracranial dural arteriovenous fistula(dAVF)was incidentally detected in a 39-year-old man during a medical checkup. Except for a mild episode of pneumonia at the age of 22 years, his medical history was unremarkable. He had no family history of hereditary hemorrhagic telangiectasia(HHT). The dAVF was treated radically via ligation of the fistula, without any complications. Postoperative angiography demonstrated that the dAVF had completely healed, but showed an aberrant, dilatated, and tortuous internal mammary artery...
September 2016: No Shinkei Geka. Neurological Surgery
Fengli Fu, Jiahu Yang, Jianjun Zhang, Yue Feng
BACKGROUND: Crossed pulmonary arteries or single atrium is a rare form of cardiovascular anomaly. In previous studies, the anomalies are detected in infant or early adolescence, and infrequently seen in adult population. CASE PRESENTATION: We presented a case of the coexistence of two congenital anomalies in a 44-year-old woman who remained well tolerated and undiscovered until adulthood. Physical examination showed a grade III systolic murmur at the cardiac apex, and a grade II/III systolic murmur at left 2-3 intercostal space...
2016: BMC Cardiovascular Disorders
Rie Nishikata, Naho Kato, Miwako Suto, Mami Rinnou, Ikubumi Mizusawa, Naohito Kuroda
Ventricular septal defect (VSD) has a relatively non-aggressive clinical course; either spontaneous closure or causing congestive heart failure treatable with surgical intervention. We present two autopsy cases of sudden infant deaths from clinically undiagnosed VSDs. Case 1 was an 18-day-old boy. As the deceased coughed and became limp after feeding, he was carried to a hospital. Heart murmur was not auscultated there, so he was brought back to home. He presented severe dyspnea and then he was pronounced dead the next day...
September 2016: Legal Medicine
Padmanabhan Premkumar
Valvular heart disease is a common condition in today's patient population. Accurate characterization of vital cardiac structures has become crucial to early diagnosis and varied treatment options. The advent of ultrasound technology has had a large impact in cardiovascular medicine, particularly in the assessment of valvular heart disease. Today its versatility and availability have allowed it to become one of the most frequently ordered imaging tests for cardiovascular indications. Despite the tremendous evidence that suggests that clinical examinations are still standard of care, a large volume of referrals for echocardiograms suggests differently...
September 2016: Medical Clinics of North America
S L Roberts, J Dukes-McEwan
The Donkey Sanctuary (DS) owns 3500-4000 donkeys, estimated to be about 35 per cent of the UK population. Although postmortem surveys suggest a high prevalence of cardiovascular disease in donkeys, there is sparse clinical information about cardiovascular examination findings and echocardiographic findings in health and disease. In this cross-sectional study, auscultation findings were recorded, and in a subset of donkeys, echocardiography was used to screen for structural and functional cardiac disease. 202 donkeys were examined; 117 geldings and 85 females...
October 15, 2016: Veterinary Record
C Misbach, P Pey, V Gouni, E Trehiou-Sechi, A M Petit, J Pouchelon, V Chetboul
A 14-year-old neutered male crossbreed dog was presented for weakness, cough and weight loss. Cardiac auscultation revealed tachycardia, arrhythmia and a grade V/VI left apical systolic heart murmur. Thoracic radiographs showed a large homogeneous soft tissue opacity in close contact with the cardiac silhouette in the left cranioventral mediastinum. Cardiac evaluation showed atrial fibrillation, degenerative mitral valve disease and a dilated left auricular appendage outside the pericardium consistent with herniation through a partial pericardial defect...
May 2016: Schweizer Archiv Für Tierheilkunde
Eric McWilliams, Kenton Zehr, Ali Alshehri
CLINICAL INTRODUCTION: A 55-year-old West African man was referred for routine echocardiography. He was completely asymptomatic, a non-smoker, working out at the gym several times weekly. He was taking hydrochlorothiazide for hypertension.Clinical examination revealed a blood pressure of 156/74 mm Hg and systolic and diastolic murmurs suggestive of aortic insufficiency. Pulses were equal bilaterally and he had no marfanoid features or hyperelasticity. ECG showed mild left ventricular hypertrophy and chest X-ray revealed a normal cardiac shadow and mediastinum...
August 11, 2016: Heart: Official Journal of the British Cardiac Society
Nicla A Varnier, Sarah Chwah, Trent Miller, Franziska Pettit, Mark Brown, David Rees, Amanda Henry
BACKGROUND: Shortness of breath is a common physiological pregnancy presentation, secondary to both hormonal and mechanical effects. Its pathological causes are common (asthma exacerbation or infection); new-onset cardiac pathology is rarely considered. CASE: JC, a 39-year old G4P2T1, presented at 34 weeks' gestation with shortness of breath unrelieved by salbutamol. History included asthma, poly-drug abuse and smoking. Initial presentation was consistent with asthma exacerbation and she was treated as such...
September 2015: Obstetric Medicine
Yoshie Sakasai, Akinobu Sasaki, Osamu Shigeta, Yasuaki Tsumagari, Hidekazu Tsuneoka, Masako Misaki, Noriyuki Takeyasu
A 77-year-old woman presented with a 3-week history of low grade fever, appetite loss and dizziness. An electrocardiogram showed complete heart block. Echocardiography demonstrated severe aortic valve stenosis and a mass of probable vegetation 2 cm in diameter on the atrioventricular septum in the right atrium (RA), but no obvious intra-cardiac fistula. There was no growth of organism in blood cul tures. In the 4th week after admission, a harsh and continuous cardiac murmur was detected for the 1st time. Portable echocardiography revealed disappearance of the mass in the RA, and showed an intra-cardiac shunt from the left ventricle( LV) to RA...
August 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Jason M Tarkin, James H F Rudd, David R Jayne, Rosemary A Rusk, Deepa Gopalan
CLINICAL INTRODUCTION: A 57-year-old woman presented to our clinic with breathlessness brought on while walking uphill. She had been recently diagnosed with systemic hypertension. There was no known family history of cardiac disease, or prior smoking habit. On examination, pulse was 73 bpm and blood pressure 155/73 mm Hg, which was asymmetrical in her arms. Auscultation revealed a readily audible early diastolic murmur in the aortic area and bilateral subclavian bruits. ECG showed sinus rhythm with no abnormality...
July 13, 2016: Heart: Official Journal of the British Cardiac Society
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