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Andrew J Bradley, Jannet F Lewis, Andrew D Choi
CLINICAL INTRODUCTION: A 63-year-old man with HIV presented with 1 month of dyspnoea and productive cough without orthopnoea. He was afebrile with normal blood pressure, borderline tachycardia and mild pulmonary wheezing. He had exertional hypoxia requiring 4 L per minute of oxygen. No murmurs, jugular venous distention or lower extremity oedema was noted. Clinical evaluation included transthoracic echocardiography (TTE), which showed mild left ventricular hypertrophy with normal size and systolic function...
June 22, 2018: Heart: Official Journal of the British Cardiac Society
Renwei Chen, Xicheng Deng, Jinwen Luo, Peng Huang
INTRODUCTION: Cardiac myxomas are the most frequent primary cardiac tumor in adults. The incidence in pediatric patients is extremely low. Heavy calcification of an atrial myxoma is uncommon in children. CASE PRESENTATION: An 18-month-old boy was admitted for a significant precordial systolic murmur. Transthoracic echocardiography revealed a cardiac mass extending from the inferior vena cava across the right atrium and tricuspid valve into the right ventricle with severe tricuspid regurgitation...
June 2018: Medicine (Baltimore)
Pairoj Chattranukulchai, Jule Namchaisiri, Monravee Tumkosit, Sarinya Puwanant, Yongkasem Vorasettakarnkij, Suphot Srimahachota, Smonporn Boonyaratavej
BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly. The enlarged right coronary artery provides retrograde collaterals to supply the left ventricle then preferentially directs into the lower pressure pulmonary artery system causing coronary steal phenomenon. Few patients who survive through adulthood without surgery must have abundant, well-formed functioning collaterals with adequate perfusion of the left ventricle...
June 18, 2018: Journal of Cardiothoracic Surgery
Manasawee Indrabhinduwat, Maria C Arciniegas Calle, Joseph P Colgan, Benoy N Villarraga
A 37-year-old male presented with cough, dyspnea, significant weight loss (45 pounds) and subacute fever for the past two 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...
June 12, 2018: Echo Research and Practice
Arnar B Ingason, Gunnlaugur Sigfusson, Bjarni Torfason
BACKGROUND: Unicuspid unicommissural aortic valve is an extremely rare congenital anomaly that usually presents in adulthood but can rarely present in infancy. We report a 17-year-old patient with congenital aortic stenosis secondary to unicuspid unicommissural aortic valve that was successfully treated with aortic valve replacement. CASE PRESENTATION: The patient was diagnosed with aortic stenosis after a murmur was heard in the newborn nursery and subsequently underwent aortic balloon valvuloplasty 6 weeks after birth...
June 7, 2018: Journal of Cardiothoracic Surgery
Zorica Mladenovic, Danijela Vranes, Slobodan Obradovic, Boris Dzudovic, Andjelka Angelkov Ristic, Nenad Ratkovic, Zoran Jovic, Marijan Spasic, Jelena Maric Kocijancic, Predrag Djruic
Unicuspid aortic valve (UAV) is a rare congenital anomaly of aorta associated with a faster progress of valvular dysfunction, aortic dilatation and with necessity for more frequent controls and precise evaluation Asymptomatic 35 year old man had abnormal systolic diastolic murmur on aortic valve during routine examination. Initial diagnostic with transthoracic echocardiography (TTE) supposed bicuspid aortic valve, while three-dimensional transesophageal echocardiography (3D TEE) and multidetector computed tomography defined unicuspid, unicomissural aortic valve with moderate aortic stenosis and regurgitation...
June 4, 2018: Echocardiography
Do Wan Kim, In Seok Jeong, Ja Hae Kim, Yun Hyeon Kim, Hwa Jin Cho
An anomalous systemic arterial supply to a normal lung is a rare congenital anomaly, and then for which no standard treatment has been established. We present the case of a 7-month-old girl who had a continuous murmur at the trunk. She was diagnosed the anomalous systemic arterial supply to the left lower lobe, we decided to perform an end-to-side anastomosis between the abnormal systemic artery and left pulmonary artery. After 3 years, the patient showed the normal lung perfusion of the operation lobe.
April 2018: Journal of Thoracic Disease
Michiyo Yamano, Tatsuya Kawasaki, Hirokazu Shiraishi, Tadaaki Kamitani, Takatomo Shima, Takashi Nakamura, Satoaki Matoba
A diastolic paradoxical jet flow, often seen in patients with hypertrophic cardiomyopathy, is a unique flow from the apex toward the base of the left ventricle during isovolumic relaxation. To date, this phenomenon appears to have been noninvasively detected only on echocardiograms. We report the case of a 43-year-old man with hypertrophic cardiomyopathy and a diastolic paradoxical jet flow, in whom cardiac auscultation revealed a soft S4 , a systolic ejection murmur, and a low-pitched early diastolic murmur immediately after S2 at the apex...
April 2018: Texas Heart Institute Journal
Moisés Rodríguez-González, Almudena Alonso-Ojembarrena, Ana Castellano-Martínez, Lorena Estepa-Pedregosa, Isabel Benavente-Fernández, Simon P Lubián López
INTRODUCTION: Current guidelines in Spain recommend performing transthoracic echocardiography (TTE) in all children under 2 years of age with a heart murmur. In 2014, the American Paediatric Association published the first appropriate use criteria (AUC) for outpatient paediatric transthoracic echocardiography (TTE) to promote its cost-efficient use. The aim of this article is to analyse the AUC and other clinical factors as predictors of congenital heart disease (CHD) in children less than 2 years of age with a heart murmur, and to develop a safe and efficient referral strategy...
May 23, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
D Nestel, N McNaughton, C Smith, C Schlegel, T Tierney
This article has been written for the 40th year of the publication of Medical Teacher. While we celebrate the contribution of simulated participants (SPs) to health professions education through values and value-based learning, we also offer critical reflection on elements of our practice, commencing with language. We argue for the use of the term simulated rather than standardized and acknowledge the dominant role of the SP as patient and the origins of the methodology. These shifts in terms and their implications in practice reflect changes in the conceptualization of SP-based methodology...
May 25, 2018: Medical Teacher
Kentaro Tanaka, Masaru Isihida, Ryoichi Tanaka, Tomonori Itoh, Yujiro Naganuma, Takuya Osaki, Kunihiro Yoshioka, Yoshihiro Morino
A 75-year-old woman with chest discomfort and a continuous murmur was admitted to our hospital. During noninvasive examination, computed tomography angiography showed a coronary artery-pulmonary artery fistula with double giant coronary aneurysms (one was 42 mm× 32 mm× 32 mm, and the other was 25 mm× 20 mm× 17 mm) arising from the proximal part of the left anterior descending (LAD) artery. Stress myocardial scintigraphy showed ischemia at the LAD area. Given her frailty, the heart team, including cardiac surgeons, judged that surgical treatment would be difficult...
May 23, 2018: International Heart Journal
Arsalan Majeed Adam, Ansab Godil, Muhammad Saad Ali Mallick, Fahad Khan, Ather Hasan Rizvi, Inam-Ul-Haq Muhammad Makhdoom
Lutembacher syndrome is characterized by a congenital ostium secundum atrial septal defect and an acquired mitral valve stenosis. We present a similar case in a 31-year old male who came in with orthopnoea, central cyanosis and pedal oedema. Examination revealed cardiac murmurs in tricuspid and apical regions. Chest x-ray showed signs of pulmonary congestion and ventricular enlargement. Electrocardiogaphy (ECG) revealed right axis deviation and right bundle branch block along with atrial fibrillation and Transthoracic Echocardiography (TTE) showed abnormal valves (mitral stenosis with calcification and tricuspid regurgitation) and dilated cardiac chambers...
February 2018: JPMA. the Journal of the Pakistan Medical Association
Abdalla Ibrahim, Aneeq Ahmed, Thomas Kiernan, Samer Arnous
An 87-year-old woman presented to the emergency department with a 2-week history of progressively worsening shortness of breath, fever and generalised myalgia. She underwent a transcatheter Portico aortic valve implantation for severe symptomatic aortic stenosis 3 months prior to this presentation. Examination revealed a temperature of 40°C and a systolic murmur in the aortic area. Inflammatory markers were elevated, and blood cultures were positive for methicillin-sensitive Staphylococcus aureus A possible diagnosis of infective endocarditis was made as one major and one minor criterion in the modified Duke criteria were fulfilled...
May 14, 2018: BMJ Case Reports
Ramya Deepthi Billa, Susan Szpunar, Lida Zeinali, Premchand Anne
The yield of outpatient echocardiograms varies based on the indication for the echocardiogram and the age of the patient. The purpose of this study was to determine the cumulative yield of outpatient echocardiograms by age group and reason for the test. A secondary aim was to determine the predictors of a positive echocardiogram in an outpatient cardiology clinic at a large community teaching hospital. We retrospectively reviewed the charts of 891 patients who had a first-time echocardiogram between 2011 and 2015...
2018: Global Pediatric Health
Nurdan Erol, Metin Yıldız, Ayla Güven, Ayse Yıldırım
BACKGROUND: Laron syndrome (LS), which can be defined as primary growth hormone resistance or insensitivity, is a rare genetic disease inherited by an autosomal recessive trait. Although it is undistinguishable from growth hormone deficiency, LS has high levels of growth hormone, but insulin-like growth factor (IGF-1) cannot be synthesized. Mecasermin treatment is the only option for the patients who suffer from LS. This study aims to research cardiac findings of children with LS, who receive treatment with mecasermin...
May 11, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Dardan Koçinaj, Xhevdet Krasniqi, Aurora Bakalli
BACKGROUND: Immature teratoma in a mediastinal location is a rare disease that might present as a valve pathology. Germ cell tumors with mediastinal locations account for up to 6% of immature teratoma cases. We present a case of an immature teratoma located primarily in the anterior mediastinum that manifested solely through symptoms of pulmonary stenosis. CASE PRESENTATION: We report a case of a 20-year-old white man with an immature teratoma who presented with progressive exertional dyspnea...
May 9, 2018: Journal of Medical Case Reports
Fei-Fei Zhao, Yang Lu, Hui Ye, Ce-Jun Zhong, Liang Huang, Xiao-Ju Lü
OBJECTIVE: To analyze the clinical characteristics of infective endocarditis (IE) in culture-positive patients,so as to provide the evidences for reasonable diagnosis and treatment of IE. METHODS: We performed a retrospective study of 157 culture-positive IE cases,which were diagnosed according to modified Duke criteria for IE from Jan. 2008 to Aug. 2015. RESULTS: The average age of 157 cases of IE was 40.85 years. One hundred and one patients (64...
January 2018: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
Ajoe John Kattoor, Anusha Shanbhag, Annette Abraham, Srikanth Vallurupalli
OBJECTIVES: Auscultation is an important clue to the presence of aortic stenosis (AS). We sought to assess the effect of symptom status, prior knowledge of diagnosis, and other patient factors on murmur detection. METHODS: Patients with moderate-to-severe AS by echocardiography at a single center between June 2015 and June 2016 were included. Five consecutive patient encounters (inpatient and outpatient) within 12 months before the echocardiogram were analyzed. RESULTS: Ninety-five patients (418 different clinician encounters) were studied...
April 2018: Southern Medical Journal
V Gouni, S Papageorgiou, J Debeaupuits, C Damoiseaux, J Pouchelon, V Chetboul
Aortic dissection is characterized by a tear in the aortic wall resulting in blood from the aortic lumen penetrating into the media, which causes dissection. When aortic dissection does not cause rupture, it provokes localized dilation of the aorta or aneurism, also called dissecting aortic aneurism (DAA). This case report describes a DAA in a cat associated with systemic arterial hypertension (SAHT). A 10-year-old male Domestic shorthair cat was presented for cardiac evaluation. Anamnestic clinical complaints were a syncope associated with paraparesis and weak femoral pules...
May 2018: Schweizer Archiv Für Tierheilkunde
Tomas Jurko, Alexander Jurko, Jana Krsiakova, Alexander Jurko, Milan Minarik, Michal Mestanik
Introduction LEOPARD syndrome is a rare genetic disorder characterised by lentigines, electrocardiographic conduction abnormalities, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, retardation of growth and sensorineural deafness. Clinical manifestations are often mild, which may result in difficult and late diagnosis. Cardiac involvement may have a significant impact on the prognosis, however, appearance of severe abnormalities such as hypertrophic cardiomyopathy usually precedes the occurrence of multiple lentigines and may be asymptomatic...
May 2, 2018: Acta Clinica Belgica
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