RESUMEN
A patient with a Kay-Shiley mitral prosthesis had abnormal intermittent systolic tilting of the prosthetic disc by cinefluoroscopy. Echocardiography revealed an abnormal "atrial emptying index" consistent with mitral obstruction. Catheterization revealed mitral regurgitation without stenosis. At surgery, there was no prosthetic orifice obstruction. It was concluded that the atrial emptying index may be abnormally low in prosthetic mitral regurgitation without stenosis.
Asunto(s)
Ecocardiografía , Prótesis Valvulares Cardíacas/efectos adversos , Insuficiencia de la Válvula Mitral/diagnóstico , Cateterismo Cardíaco , Humanos , Masculino , Persona de Mediana Edad , Válvula Mitral/cirugía , Insuficiencia de la Válvula Mitral/etiología , Estenosis de la Válvula Mitral/diagnóstico , Válvula Tricúspide/cirugíaRESUMEN
Atresia of the aortic arch is distinguished from complete interruption of the aorta by the presence of a fibrotic strand bridging the 2 discontinuous segments of aorta. Most patients with aortic arch atresia have associated intracardiac defects. There is a high neonatal mortality in this condition, with 95% of the patients dying in the first year of life. The case described herein is the first long-term survivor with atresia of the aortic arch, a patent ductus arteriosus, and an atrial septal defect to reach adulthood. In this patient an extensive collateral network existed in spite of the presence of a patent ductus arteriosus.
Asunto(s)
Aorta/anomalías , Adulto , Enfermedades de la Aorta/clasificación , Circulación Colateral , Circulación Coronaria , Conducto Arterioso Permeable/complicaciones , Humanos , MasculinoRESUMEN
To determine the variables that might affect interpretability of myocardial perfusion images in patients with acute myocardial infarctions, images obtained following intravenous administration of potassium-43 or cesium-129 were evaluated in 68 patients with nonacute coronary or noncoronary heart diseases, who were undergoing cardiac catheterization. Severe coronary arterial disease usually produces no distinctive perfusion defects in the resting state. Remote infarcts likewise tend to remain undetectable unless accompanied by wall-motion disturbances that can be detected by ventriculography. Left ventricular hypertrophy or cardiac dilatation can produce perfusion patterns indistinguishable from the ischemic defects of infarction. Right ventricular hypertrophy can cause image alterations that mimic infarcts in the left ventricle. In patients with acute myocardial infarction, sequential imaging studies with perfusion indicators should be of value in determining the effects of various therapeutic maneuvers on regional myocardial perfusion, but variations caused by conditions other than acute vascular occlusion limit the usefulness of perfusion imaging for diagnosing acute infarction. In suspected acute infarction, perfusion imaging will be used most effectively in conjunction with other imaging or nonimaging procedures that show the presence of damaged or necrotic myocardium. The information derived from this study should be generally applicable to the interpretation of imaging results obtained with the newer indicators of myocardial perfusion now in use or under development.
Asunto(s)
Cardiomegalia/diagnóstico , Enfermedad Coronaria/diagnóstico , Enfermedades de las Válvulas Cardíacas/diagnóstico , Cintigrafía , Adulto , Anciano , Angina de Pecho/diagnóstico , Radioisótopos de Cesio , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Radioisótopos de PotasioRESUMEN
A mobile left ventricular tumor was detected by echocardiography. The tracing showed a cluster of echoes in the left ventricular cavity corresponding to the location of the tumor as seen in angiograms. At surgery the tumor was attached to the interventricular septum by a thin fibrous stalk.
Asunto(s)
Ecocardiografía , Cardiopatías/diagnóstico , Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Trombosis/diagnóstico , Diagnóstico Diferencial , Cardiopatías/patología , Neoplasias Cardíacas/patología , Ventrículos Cardíacos/patología , Humanos , Masculino , Persona de Mediana Edad , Mixoma/patología , Trombosis/patologíaRESUMEN
Obtaining high resolution static films through an image intensifier has been made possible by recent developments in radiographic equipment. Serial photofluorography 105 mm spot filming has been used successfully to complement cine coronary arteriography in approximately 700 patients. Many patients with coronary heart disease have diffuse peripheral atheromatous changes which are also suitable to study by serial 105 mm photofluorography. Aortic arch, abdominal aortography, and peripheral studies are easily and quickly performed in conjunction with coronary arteriography. Satisfactory results still depend upon skillful application by the angiographer of this imaging mode and proper processing of the film. Advantages of photofluorographic filming over conventional large film techniques include lower radiation exposure, reduction of costs, and easier film handling and storage. Most important is the facilitation of the performance of angiographic studies since constant television monitoring of the catheter and the contrast injections is possible. Disadvantages include restricted area of coverage and slight decrease in resolution. Our experience indicates that photofluorography may be relied upon in the study of vascular disease eliminating the need for large film changers in a laboratory used primarily for cardiac diagnosis.