RESUMEN
A 36-year-old woman was referred because of a continuous cardiac murmur. Standard transthoracic two-dimensional echocardiography was normal. Using the transverse plane of biplane transesophageal echocardiography (TEE) a distinct dilatation of the proximal portion of the right coronary artery could be visualized. Morphology and the information from color-coded Doppler echocardiography were consistent with a coronary artery fistula. However, the exact course of the fistula and its drainage could not be seen. Only by using the longitudinal plane of biplane TEE its site of drainage into the vena cava superior could be demonstrated morphologically, as well as by color-coded Doppler imaging.
Asunto(s)
Anomalías de los Vasos Coronarios/diagnóstico por imagen , Ecocardiografía , Vena Cava Superior/anomalías , Adulto , Velocidad del Flujo Sanguíneo/fisiología , Ecocardiografía Doppler , Femenino , Hemodinámica/fisiología , Humanos , Vena Cava Superior/diagnóstico por imagenRESUMEN
On the basis of guidelines issued by the Kassenärztliche Vereingung Hessen, some criteria for the application of sonographic examinations are presented. Minimal requirements for sonographic equipment in certain specialties are mentioned, and it is pointed out how not only case history and clinical examination but also one's own sonographic evidence are important for a accurate sonographic diagnosis.
Asunto(s)
Ultrasonografía/métodos , Abdomen , Enfermedades de la Mama/diagnóstico , Ecocardiografía/métodos , Femenino , Humanos , Masculino , Embarazo , Complicaciones del Embarazo/diagnóstico , Enfermedades de la Próstata/diagnóstico , Control de Calidad , Ultrasonografía/instrumentaciónRESUMEN
A case of infundibular pulmonary stenosis occurring years after a mediastinal radiation for Hodgkin's disease is reported. As far as the literature is known to us, a similar case has not yet been described. It is most likely that the development of the stenosis is due to the radiation therapy, since a murmur was not heard before radiation and a mild stenosis was proved several years after radiation. Now, a high gradient with the typical signs of an infundibular pulmonary stenosis was present. Unfortunately the patient refused the operation. Further possibilities for acquired pulmonary stenosis and cardial complications after mediastinal radiation for Hodgkin's disease will be discussed.
Asunto(s)
Cardiomiopatía Hipertrófica/etiología , Enfermedad de Hodgkin/radioterapia , Estenosis Subvalvular Pulmonar/etiología , Estenosis de la Válvula Pulmonar/etiología , Traumatismos por Radiación/etiología , Adulto , Cateterismo Cardíaco , Radioisótopos de Cobalto/efectos adversos , Diagnóstico Diferencial , Femenino , Hemodinámica/efectos de la radiación , Humanos , Pericarditis/etiología , Válvula Pulmonar/efectos de la radiación , Teleterapia por Radioisótopo/efectos adversosRESUMEN
The use of CT has rarely reported in the work-up of cardiac patients. A case of a tumor in the wall of the left ventricle is reported which was much better visualized in regard to size, shape, and density by CT than by cardiac scanning and angiography.
Asunto(s)
Neoplasias Cardíacas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Diagnóstico Diferencial , Electrocardiografía , Humanos , MasculinoAsunto(s)
Pulmón/anomalías , Linfedema/complicaciones , Adulto , Angiografía , Humanos , Masculino , Arteria Pulmonar/anomalíasRESUMEN
1500 men (aged 30-55 years) volunteered in a trial of early recognition of cardiovascular disease. History and clinical as well as biochemical data were obtained and compared with results of exercise ECGs. In the group as a whole abnormal ECGs were obtained in 6.2%, in a subgroup of those without exercise-dependent pain in the thorax, without hypertension and noraml resting ECG it was 3.8%, while in the presence of one or several of these risk factors it was as high as 17.8%. It is concluded that in any screening programme it is not reasonable to perform exercise ECGs in asymptomatic persons without risk factors, because in this group there is likely to be only a small percentage of abnormal findings and the number of false-positive ones is higher than that or correct positive ones. In connection with the known risk factors and risk indicators it would be best to define the risk group and, using selective indications, to go step-by-step from exercise ECG to additional invasive diagnostic measures such as coronary angiography.