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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In an 82-year-old female case of endocardial cushion defect (ECD), a systolic regurgitant murmur was heard at the apex, and her ECG showed atrial fibrillation without right bundle branch block or left axis deviation. An echocardiogram demonstrated atrial septal defect (ASD) and a cleft of the anterior mitral leaflet with calcification. She died of refractory congestive heart failure. Autopsy revealed ECD (intermediate type) with mitral and tricuspid cleft, and ASD (ostium primum type, 2.0 x 1.0 cm in diameter). In addition, mitral ring calcification and calcification of the cleft mitral valve was disclosed, causing mitral stenosis in addition to mitral regurgitation due to the cleft mitral valve. This was the second oldest Japanese autopsy case of ECD. We concluded that echocardiographic examinations, including color flow imaging, in aged patients with heart murmur are necessary to confirm the diagnosis of congenital heart disease in the aged.
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PMID:[An autopsy case of endocardial cushion defect (ECD) in an 82-year-old female]. 150 14

Ultrafast computed tomography (CT) and magnetic resonance imaging (MRI) generate high resolution tomographic cardiac images. Ultrafast CT requires intravenous injection of x-ray contrast combined with an image acquisition time of 50 msec. MRI requires no contrast injection, but has relatively long acquisition times due to gating. Both technologies can be used to evaluate cardiac chamber and great vessel dimensions, intracardiac and extracardiac masses, ventricular hypertrophy, left ventricular mass, congenital heart disease, regional and global left ventricular function, right ventricular function and pericardium. MRI is highly useful for detection and semi-quantitation of valvular regurgitation while ultrafast CT is not. Aortic and mitral valve stenosis can be detected by both, but MRI is the preferred study. Though both techniques can be used to assess coronary artery bypass graft status, ultrafast CT is the preferred method. It is concluded that ultrafast CT and MRI have broad applications for cardiac diagnosis.
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PMID:Magnetic resonance imaging vs. ultrafast computed tomography for cardiac diagnosis. 152 44

The association of tetralogy of Fallot and mitral stenosis is extremely rare. This is probably the first description of this association. The clinical and haemodynamic presentation is similar to that of cyanotic heart disease with pulmonary stenosis and post-capillary pulmonary hypertension. The mitral stenosis was probably congenital as it was diagnosed at 14 months of age.
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PMID:[Tetralogy of Fallot and mitral valve stenosis]. 153 Apr 4

A 20-year-old woman with complex cyanotic congenital heart disease, including severe congenital mitral stenosis and intact atrial septum, who developed a left atrial ball thrombus and an embolic phenomenon, is presented. Increased vigilance in this unique setting is necessary for the antemortem detection of this rare complication.
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PMID:Development of a left atrial ball thrombus in a woman with complex congenital heart disease including congenital mitral valve stenosis. 160 18

A case of congenital mitral stenosis with pulmonary hypertension is presented. The severity and rapid development of the pulmonary vascular changes are unusual, especially for a young child. The case underscores the importance of early detection of correctable congenital heart disease and emphasizes the unpredictability of the time course and severity of irreversible pulmonary hypertension.
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PMID:Pulmonary hypertension with necrotizing arteritis secondary to congenital mitral stenosis. 167 84

Atrial flutter is associated with a macro-reentrant loop including an area of slow conduction cryoablation of which prevents atrial flutter to occur. Three patients underwent such intervention. Atrial fibrillation is associated with multiple reentrant circuits (leading circle of Allessie) that requires a critical surface area to perpetuate. We have designed an operation, the corridor operation, which isolate the sinus node and the AV node within a small segment of atrial tissue, to restore the chronotropic function of the sinus node. Nine patients underwent the corridor operation at our institution. There were eight men and one woman. Five had incessant atrial fibrillation and four paroxysmal. One patient had associated mitral valve stenosis and one cardiomyopathy. There were no perioperative complications. Six patients had normal sinus node function postoperatively including all the four patients with documented normal sinus node function preoperatively. Three patients required implantation of an AAI pacemaker. Two patients had recurrence of atrial fibrillation within the corridor. Our experience suggests that the corridor operation should be restricted to patients with documented good sinus node function and without structural heart disease. Our experience with five patients with paroxysmal sinus node tachycardia has been disappointing. Only one patient had long-term success although better series have been published.
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PMID:Surgery for atrial tachycardia. 170 81

To describe the incidence of mitral valve abnormalities among infants aged 0 to 24 months, their anatomic features, site of lesion, severity and associated heart defects, the records of 3,583 such patients submitted for bi-dimensional ultrasound and pulsed Doppler cardiac studies by presumptive heart disease were analyzed. Mitral valve abnormalities were thus detected in 88 of these cases, and were also documented by clinical examination (n: 88), heart catheterization and angiocardiography (n: 11), surgery (n: 17) and necropsy (n: 2). Seventy five cases had additional heart disease, most commonly aortic stenosis (27%), aortic coarctaction (26%) and ventricular septal defects (43%). Papillary muscle deformities at the subvalvar mitral apparatus were considered to be the most frequent mechanism for congenital mitral stenosis (100%), and annulus dilatation was the most frequent cause of mitral insufficiency (49%). Relative incidences of mitral valve stenosis and insufficiency among the whole studied sample were 0.5% and 1.48% respectively. There was a rough correlation between Doppler transmital gradient or regurgitation jet area and the corresponding mitral valve abnormality. This kind of noninvasively obtained data about mitral architecture and function seems to be a very useful and sensitive guide to define and manage this patients.
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PMID:[Mitral valve disease in infants. Anatomical and functional evaluation by echocardiography]. 184 38

To determine the clinical significance and effect of cycle length on systolic backward (C) and forward (S) flow patterns of the pulmonary vein, we performed transesophageal and transthoracic echocardiography in patients with atrial fibrillation (Af). Study population consisted of 10 patients with mitral stenosis and sinus rhythm (MS-SR), 15 with MS and Af (MS-Af), 15 with mitral valve replacement and Af (MVR-Af), 10 with Af without organic heart disease (lone-Af) and 15 normal subjects. Various parameters, including peak velocities of C and S waves, closing amplitude of anterior mitral valve echogram during end-diastole, amplitude of the mitral annulus and interatrial septal motion during systole and left atrial pressure during the mitral closing period or end-diastole, were measured in each group. Results were as follows: 1. C wave was observed in all Af groups and six of 10 patients with MS-SR. Particularly, peak velocity of the C wave in MS-Af group was increased significantly compared with those of every other group. 2. Peak velocity of S wave in all Af groups, particularly in MS- and MVR-Af groups, decreased significantly compared with that of the normal group. 3. There were significant negative correlations between preceding R-R interval and peak velocity of the C wave or closing amplitude of anterior mitral valve echogram or left atrial pressure during end-diastole in MS-Af group. 4. There were significant positive correlations between preceding R-R interval and peak velocity of the S wave or amplitude of the mitral annulus or interatrial septal motion during systole in MS-Af group. 5. Peak velocities of the C and S waves had no correlations to preceding R-R interval in lone-Af group. We concluded that the C and S waves of pulmonary venous flow velocity pattern in MS-Af are affected by cycle length, and that the former is influenced by left atrial pressure and/or pliability of the mitral valve during the mitral closing period, and the latter by the grade of left atrial dilatation and/or preceding left atrial emptying.
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PMID:[Transesophageal echocardiographic study on systolic flow pattern of the pulmonary vein in patients with mitral stenosis and atrial fibrillation]. 188 57

The total and fractional content of blood bile acids (BA) was studied by the method of thin-layer chromatography and rheohepatography was performed in 87 patients with rheumatic mitral disease (mitral stenosis and associated mitral heart disease with prevalence of stenosis). There was a direct dependence between the degree of clinical and rheohepatographic signs of disorders of the hemodynamics and increase of the level of serum BA, a more pronounced therapeutic effect with normalization of BA, concentration in the blood after complex treatment using hepatotropic drugs than with use of traditional drugs (non-steroid antiinflammatory, cardiac glycosides, diuretics and others.).
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PMID:[Bile acid levels in the serum and the state of liver blood flow in patients with rheumatic mitral heart disease]. 189 50

Commissural fusion, leaflet thickening and alteration of the subvalvular apparatus are dominant mechanisms causing clinically important mitral stenosis (MS) of rheumatic origin. Calcification and a consequent decrease in leaflet mobility are subsequent features in rheumatic MS and may be the primary mechanisms in MS of degenerative origin. In 1051 consecutive patients with pure or predominant MS requiring surgical intervention, aetiology was rheumatic in 76.9%, infective in 3.3%, degenerative (severe annular and leaflet calcification) in 2.7% and congenital (Lutembacher syndrome) in 1.2%; it was the result of systemic lupus erythematosus (n = 4), carcinoid heart disease (n = 2), endomyocardial fibrosis (n = 2) and rheumatoid arthritis (n = 2) in less than 1%, while in 14.5% of these patients aetiology remained unclassified. The natural history of rheumatic MS is characterized by an asymptomatic latent period, following the initial rheumatic fever (RF). In a prospective study of MS (n = 159) the mean interval between RF and the appearance of symptoms was 16.3 +/- 5.2 years. Twenty-five years after the initial RF 8% of the patients were still asymptomatic, 9% were class II (NYHA), 33% class III and 50% had been operated or were class IV. Progress from mild to severe disability took 9.2 +/- 4.3 years on average. When valve surgery was indicated but refused by the patients, survival with medical treatment was 0.44 +/- 0.06 after 5 years, 0.32 +/- 0.08 after 10 years and 0.19 +/- 0.09 after 15 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pathomorphological aspects, aetiology and natural history of acquired mitral valve stenosis. 193 27


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