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https://www.readbyqxmd.com/read/29279077/platypnea-orthodeoxia-syndrome-after-complicated-cholecystectomy-an-unsuspected-diagnosis
#1
Catarina Queirós, Elsa Francisco, João Almeida
A 65-year-old woman with no significant prior medical history presented, in the postoperative course of a complicated cholecystectomy, several episodes of arterial desaturation. Pulmonary embolism was repeatedly suspected, but there was no evidence of pulmonary thrombus on the chest computed tomography angiographies obtained. As these episodes were mainly induced by postural changes, a platypnea-orthodeoxia syndrome was suspected. A transthoracic echocardiogram was performed and revealed a patent foramen ovale...
November 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29276443/ruptured-sinus-of-valsalva-aneurysm-associated-with-situs-ambiguus-isolated-levocardia-and-polysplenia
#2
Safieh Golestaneh, Mohammad Amin Kashef, William L Hiser, Amir S Lotfi, Timothy G Egan
Aneurysm of the sinus of Valsalva, a rare cardiac condition, results from dilation of an aortic sinus. Sudden aneurysm rupture can trigger rapidly progressive heart failure. We discuss the case of a 57-year-old woman with situs ambiguus, isolated levocardia, and polysplenia who presented with acute-onset heart failure. Transesophageal echocardiograms revealed an aneurysm of the right coronary sinus of Valsalva that had ruptured into the right atrial cavity. The patient underwent successful surgical repair. To our knowledge, this is the first report of a sinus of Valsalva aneurysm in a patient with this combination of congenital abnormalities...
December 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29260427/efficacy-and-safety-of-dabigatran-in-patients-with-atrial-fibrillation-scheduled-for-transoesophageal-echocardiogram-guided-direct-electrical-current-cardioversion-a-prospective-propensity-score-matched-cohort-study
#3
Vincenzo Russo, Anna Rago, Andrea Antonio Papa, Antonio D'Onofrio, Paolo Golino, Gerardo Nigro
Patients with atrial fibrillation (AF) are predisposed to a hypercoagulable state and are at an increased risk for thromboembolic events when undergoing procedures. This study investigated the long-term efficacy and safety of newly initiated anticoagulation with dabigatran versus uninterrupted vitamin K antagonist (VKA) therapy in patients with AF scheduled for transesophageal echocardiogram (TEE)-guided direct electrical current cardioversion (DCC). Consecutive adult patients with persistent AF scheduled to undergo DCC were included in the study...
December 19, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29226430/3dtee-imaging-of-a-descending-aorta-floating-thrombus-in-a-patient-with-calciphylaxis
#4
Konstantinos C Theodoropoulos, Alexandros Papachristidis, Michael Papitsas, Jonathan Byrne, Mark J Monaghan
We present a case of a 68-year-old man with calciphylaxis, who was found to have a floating thrombus in the descending aorta on a transesophageal echocardiogram. The use of 3D echocardiography demonstrated nicely the free motion of the thrombus, emerging from an atherosclerotic plaque in the descending aorta. Anticoagulation was started for thromboembolism prevention.
December 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/29225261/a-case-of-isolated-left-atrial-infective-mural-endocarditis
#5
Saki Hosokawa, Hideki Okayama, Go Hiasa, Go Kawamura, Tatsuya Shigematsu, Tatsunori Takahashi, Yoshitaka Kawada, Tadakatsu Yamada, Hiroshi Matsuoka, Yukio Kazatani
A 52-year-old man presented with a fever and malaise. Transthoracic echocardiogram was performed because of a holosystolic murmur, which showed mitral valve prolapse and a regurgitation jet toward the posterior wall of the left atrium. There was no apparent vegetation at any valves. Blood cultures were positive for Streptococcus mitis/oralis. Transesophageal echocardiogram revealed vegetation only at the posterior wall of the left atrium exposed to the mitral regurgitant jet. We diagnosed this condition as infective mural endocarditis...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29217244/intraoperative-transesophageal-and-postoperative-transthoracic-echocardiographic-evaluation-of-a-mechanical-heart-valve-prosthesis-implanted-at-aortic-position
#6
Saravana Babu, Rupa Sreedhar, Shrinivas V Gadhinglajkar, Prasanta Kumar Dash, Subin Sukesan, Vivek Pillai, Varghese T Panicker, Lovhale Pravin Shriram, Neelam Aggarwal
OBJECTIVE: The aims of this study were to evaluate the intraoperative transesophageal echocardiographic (iTEE) characteristics and Doppler flow profile of aortic Chitra heart valve prosthesis (CHVP) under stable hemodynamic and loading conditions, and to compare and correlate the iTEE data with the postoperative transthoracic echocardiography (TTE) data obtained at 48 hours (TTE1) and 3 months (TTE2) after the surgery. DESIGN: Prospective, observational study. SETTING: University-level tertiary referral hospital...
September 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29190874/-subaortic-membrane-in-adults-a-brief-review-of-literature-apropos-of-one-case
#7
Katherine Ruiz, Jorge Curotto-Grasiosi, Rogelio A Machado, Adriana Angel, Diego Alasia, Bruno Peressotti
A 54-year-old man, ex smoker with high blood pressure and a history of possible Wolff-Parkinson-White syndrome was admitted for presenting an episode suggestive of acute coronary syndrome with immediate syncope and left bundle branch block, while performing physical activity. Angioplasty and a drug-eluting stent were performed in the left circumflex artery. Subsequently, Doppler echocardiography disclosed an image suggestive of a subaortic membrane. Given these findings, the patient underwent a 3D transesophageal echocardiogram and a magnetic resonance study, which confirmed the diagnosis of a subaortic membrane...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29187691/-tapia-s-syndrome-following-transesophageal-echocardiography-during-an-open-heart-operation-a-case-report
#8
Satoru Fujiwara, Hajime Yoshimura, Kenta Nishiya, Keiichi Oshima, Michi Kawamoto, Nobuo Kohara
A 67-year-old man presented with hoarseness, dysarthria and deviation of the tongue to the left side the day after the open-heart operation under general anesthesia. Brain MRI demonstrated no causal lesion, and laryngoscope showed left vocal cord abductor palsy, so we diagnosed him with Tapia's syndrome (i.e., concomitant paralysis of the left recurrent and hypoglossal nerve). His neurological symptoms recovered gradually and improved completely four months after the onset. Tapia's syndrome is a rare condition caused by the extra cranial lesion of the recurrent laryngeal branch of the vagus nerve and the hypoglossal nerve, and mostly described as a complication of tracheal intubation...
November 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29181735/-oral-anticoagulation-and-platelet-inhibition-after-atrial-appendage-occlusion
#9
REVIEW
Martin W Bergmann, Carsten W Israel
In Europe left atrial appendage occluders (LAAO) are most frequently used in patients with contraindications for oral anticoagulation (OAC); therefore, the classical therapeutic OAC scheme from the PROTECT-AF trial (vitamin K antagonist plus acetylsalicylic acid) is usually changed to dual anti-platelet therapy (DAPT) after implantation of a Watchman® or Amulet® LAAO (St. Jude Medical/Abbott, Eschborn, Germany). For many years, patients with an LAAO received DAPT for 1-6 months. The current standard comprises DAPT for 3 months, followed by permanent acetylsalicylic acid monotherapy if the transesophageal echocardiogram excludes a thrombus at the site of the LAAO...
December 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29181204/a-case-of-invasive-pneumococcal-infection-with-septic-shock-and-rare-complications
#10
John R Woytanowski, Nausheen Hakim, Caytlin Deering, Sara Schultz
Invasive pneumococcus is a serious illness with potentially devastating outcomes. A 64-year-old female with a medical history of psoriatic arthritis and diabetes was transferred from an outside hospital for ventilator dependent respiratory failure and altered mental status. She initially presented with worsening back pain and was found to have leukocytosis with bandemia and acute renal failure but she was in septic shock upon arrival to our tertiary care center. Her blood cultures grew Streptococcus pneumoniae and MRI of the brain revealed pus within the posterior lateral ventricles and multiple infarcts...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29180025/delay-from-diagnosis-to-surgery-in-transferred-type-a-aortic-dissection
#11
William Froehlich, Jip L Tolenaar, Kevin M Harris, Craig Strauss, Thoralf M Sundt, Thomas T Tsai, Mark D Peterson, Arturo Evangelista, Daniel G Montgomery, Eva Kline-Rogers, Christoph A Nienaber, James B Froehlich, Eric M Isselbacher, Kim A Eagle, Santi Trimarchi
OBJECTIVES: To analyze factors associated with delays to surgical management of Type A acute aortic dissection patients enrolled in the International Registry of Acute Aortic Dissection. METHODS: We evaluated 1880 surgically-managed Type A acute aortic dissection patients enrolled between 1996 and 2012 with data for times of diagnosis and surgery, accounting for demographic, clinical and diagnostic variables associated with surgical delay. RESULTS: The majority of patients were transferred (75...
November 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29178504/spontaneous-left-atrial-echo-contrast-mitral-annular-systolic-velocity-and-left-atrial-appendage-late-emptying-velocity-in-predicting-improvement-of-left-atrial-function-after-percutaneous-balloon-mitral-valvuloplasty
#12
Tirumala Naresh Arava, Rajasekhar Durgaprasad, Vanajakshamma Velam, Obul Reddy Gajjala, Vinod K Neelam, Suchitra N Manohar
BACKGROUND: Thromboembolic events are the major cause of morbidity and mortality in patients with mitral stenosis (MS). This study aims to investigate left atrial spontaneous echo contrast (LA SEC), mitral annular systolic velocity (Sa-wave), left atrial appendage (LAA) late emptying velocity (LAAEV), LAA filling velocity (LAAFV) pre- and postpercutaneous balloon mitral valvuloplasty (PBMV) for MS. This also aims to study the association of LA SEC with inflammatory marker, high-sensitivity C-reactive protein (hs-CRP) in MS...
November 26, 2017: Echocardiography
https://www.readbyqxmd.com/read/29174559/assessment-of-the-severity-of-native-mitral-valve-regurgitation
#13
REVIEW
Kinan Carlos El-Tallawi, David Messika Zeitoun, William A Zoghbi
Mitral regurgitation (MR) is a major cause of cardiovascular morbidity and mortality. MR is classified as primary (organic) if it is due to an intrinsic valve abnormality, or secondary (functional) if the etiology is because of remodeling of left ventricular geometry and/or valve annulus. Transthoracic echocardiography (TTE) is the initial modality for MR evaluation. Parameters used for the assessment of MR include valve structure, cardiac remodeling, and color and spectral Doppler. Quantitative measurements include effective regurgitant orifice area, regurgitant volume, and regurgitant fraction...
November 22, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29162223/effects-of-pectus-excavatum-repair-on-right-and-left-ventricular-strain
#14
Chieh-Ju Chao, Dawn Jaroszewski, Michael Gotway, MennatAllah Ewais, Susan Wilansky, Steven Lester, Samuel Unzek, Christopher P Appleton, Hari P Chaliki, Brantley D Gaitan, Farouk Mookadam, Tasneem Z Naqvi
BACKGROUND: The cardiopulmonary benefits of pectus excavatum repair have been debated. Echocardiographic speckle-tracking strain and strain rate have been used to evaluate and detect subclinical myocardial dysfunction in patients receiving cardiotoxic chemotherapy, and patients with valvular heart disease. This technology was applied to evaluate the effects of pectus excavatum surgery on left ventricular (LV) and right ventricular (RV) function. METHODS: Speckle tracing strain evaluation was performed on intraoperative transesophageal echocardiographic images acquired immediately before and after Nuss repair in adult patients (aged 18 years or more) from 2011 to 2014...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29154747/disseminated-methicillin-susceptible-staphylococcus-aureus-infection
#15
David R Perkins, James A Hall, Lisa M Lopez, Lizbeth Janice Cahuayme-Zuniga
INTRODUCTION: When clinicians think about Staphylococcus aureus bacteria, what comes to the mind of most is the dreaded methicillin-resistant form. However, clinicians should not forget the methicillin-susceptible type, which is just as virulent. CASE PRESENTATION: The authors present the case of a 20-year-old woman who was admitted with septic shock and multi-organ failure and was found to have disseminated methicillin-susceptible Staphylococcus aureus (MSSA) infection...
November 20, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29151509/in-paroxysmal-atrial-fibrillation-patients-the-neutrophil-to-lymphocyte-ratio-is-related-to-thrombogenesis-and-more-closely-associated-with-left-atrial-appendage-contraction-than-with-the-left-atrial-body-function
#16
Yukihiro Fukuda, Mitsunori Okamoto, Shunsuke Tomomori, Hiroya Matsumura, Takehito Tokuyama, Yukiko Nakano, Yasuki Kihara
Objective The neutrophil-to-lymphocyte ratio (NLR) is an inflammation marker that can be used to detect atrial inflammatory changes, which may contribute to a reduced left atrial (LA) function and thrombosis. Our study aimed to determine whether or not the association of NLR with the LA appendage (LAA) function in relation to thrombogenesis differs from the association with the LA body function in paroxysmal atrial fibrillation (PAF) patients. Methods A total of 183 PAF patients were studied. The LA volume index, mitral flow velocity (A), and mitral annular motion velocity (A') were examined using transthoracic echocardiography...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29151480/the-refinement-of-risk-stratification-for-atrial-thrombus-or-spontaneous-echo-contrast-in-nonvalvular-atrial-fibrillation
#17
Wenna Ning, Yang Li, Chunyan Ma, Liangxian Qiu, Bo Yu
As for nonvalvular atrial fibrillation (NVAF) patients with left atrial thrombus or spontaneous echo contrast (LAT/SEC), we evaluated the additional predictive value of serum uric acid (SUA) and Left atrial diameter (LAD) for CHADS2 and CHA2DS2-VASc, and explored the influence from the level of SUA and LAD to LAT/SEC in moderate risk group. Thus, we put forward the concept of a borderline high risk group to guide clinical anticoagulant therapy in patients with NVAF.A total of 284 NVAF patients without the history of anticoagulant prior to hospitalization were enrolled...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29142816/unilateral-pulmonary-edema-in-a-patient-with-worsening-tricuspid-valve-regurgitation-a-secret-inside-pulmonary-veins
#18
Elvira Resciniti, Ilaria Caso, Iside Scarfò, Giuseppe Di Pasquale, Giovanni La Canna
We present the case of a 69-year-old patient who was referred to the Department of Echocardiography for surgical treatment of severe tricuspid valve regurgitation (TVR) with advanced congestive heart failure. In 2013 the patient underwent unsuccessful percutaneous ablation for permanent atrial fibrillation. In 2015, following numerous episodes of atrial fibrillation and congestive heart failure with left pleural effusion, the patient was admitted to another center. A transthoracic echocardiogram showed severe TVR and moderate precapillary pulmonary hypertension, confirmed at right cardiac catheterization...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29142814/a-membranous-septal-aneurysm-causing-right-ventricular-outflow-tract-obstruction-in-an-adult
#19
Fiorella Privitera, Ines Paola Monte, Antonino Indelicato, Corrado Tamburino
We describe a case of a 69-year-old female referred for the evaluation of exertional dyspnea, with a small membranous ventricular septal defect (VSD) and right ventricle (RV) outflow tract obstruction. Using transthoracic echo was diagnosed VSD with left to right shunting and transesophageal echo (TEE) was used to a better anatomical characterization. TEE showed a perimembranous subaortic VSD that developed a high-velocity flow in RV. Pulmonary valve appears normal and right ventricular infundibular hypertrophy or double-chambered RV was excluded from the study...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29128265/atrial-flutter-has-less-left-atrial-spontaneous-contrast-and-higher-left-atrial-appendage-emptying-velocity-compared-with-atrial-fibrillation
#20
Jennifer J Huang, Sridhar Reddy, Tam H Truong, Prakash Suryanarayana, Joseph S Alpert
BACKGROUND: The risk of stroke and thromboembolism in atrial fibrillation is established. There are clear guidelines in anticoagulation management of patient's with atrial fibrillation, however, the evidence surrounding the risk of thromboembolism in patients with atrial flutter is not as clear. We hypothesized that atrial flutter would have indicators of less risk for thromboembolism compared with atrial fibrillation on transesophageal echocardiography (TEE); thereby possibly leading to a lower stroke risk...
November 8, 2017: American Journal of Medicine
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