RESUMEN
A patient who was evaluated for a syncopal episode was found by two-dimensional (2D) echocardiography to have an aneurysm of the atrial septum. The atrial septal aneurysm appeared as a localized outpouching of the atrial septum that protruded into the left atrium during systole and into the right atrium during early diastole. The 2D echocardiography permits the definitive diagnosis of this condition by a noninvasive technique.
Asunto(s)
Ecocardiografía , Aneurisma Cardíaco/diagnóstico , Atrios Cardíacos , Tabiques Cardíacos , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Síncope/diagnósticoRESUMEN
The morphology of ventricular premature beats has been described as a marker for the presence or absence of myocardial disease. Furthermore, the premature beat has been reported to be a potential marker for a dilated and hypokinetic left ventricle. To verify this previously tested hypothesis, 37 healthy patients with ventricular premature beats on an electrocardiogram (ECG), Holter monitor ECG, or a stress test ECG were classified according to the ventricular premature beat morphology. Group 1 had ventricular premature beat QRS complexes with a smooth contour or with narrow (less than 40 msec) notching. Group 2 had ventricular premature beats with broad (greater than 40 msec) notching or shelves. All of these patients had normal or borderline normal ECGs and normal multiple-gated acquisition (MUGA) scans. Nine patients had type 1 ventricular premature beats, 20 patients had type II ventricular premature beats, and eight patients had both type I and type II ventricular premature beats. We conclude that the presence of group 2 ventricular premature beats is so frequent in patients with normal left ventricular ejection fractions that the use of this marker in identifying abnormal left ventricular function is suspect.