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

Fetal echocardiography was studied by PUMC Hospital Xi' an and Harbin Medical University in collaboration. 320 fetuses were examined with M-mode. 2D and pulsed Doppler echocardiograph during one year. 7 cases of congenital heart disease were found including four ASD, one VSD, one complex deformity (single atrium, left ventricle undeveloped and pulmonary arteria) and one heart tumor (rhabdomyoma). Normal fetal echocardiographic and Doppler parameters were detected in 313 normal fetuses. The characteristic of abnormal fetal echo are: (1) The diameter of the arterial and ventricular chambers increased with increasing fetal age. (2) Fetal RV/LV = 1.1, RA greater than or equal to LA. (3) The thickness of the RV free wall is same as that of the LV free wall and septum. The fetal Doppler echo revealed: (1) The peak velocity of pulmonary artery in the early systole. (2) Peak A/Peak E greater than 1 in mitral and tricuspid valves Doppler spectra. The characteristic of fetal echocardiography consists of prominence of the right ventricle and high pulmonary pressure in the fetus.
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PMID:[Clinical study of fetal echocardiography]. 262 May 78

The records of 28 children whose first episode of paroxysmal supraventricular tachycardia occurred before 12 years (median age 10 months) were reviewed. There were 17 males and 11 females. In 17 cases the first attack occurred before the first year and in 11 of these it occurred after the first year. One case had congenital heart disease (ASD). The WPW syndrome was diagnosed in 3 cases. When first seen, most of the infants presented with signs of incipient or manifest congestive heart failure. In almost nine-tenth of cases there was an increased of serum enzymes (lactic dehydrogenase, creatine-phosphokinase and glutamic oxaloaccetic transaminase. Digitals was effective against congestive heart failure and when continued, might prevent failure during subsequent attacks. Antiarrhythmic agents other than digitals were not used. It is recommended to continue digitalis treatment for at least one year in all patients with SVT, whether or not the first episode terminated spontaneously.
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PMID:Paroxysmal supraventricular tachycardia in children: the role of infectious diseases and its relationship to serum enzyme. 263 Oct 23

The long-term follow-up status of patients operated upon for the more common forms of congenital heart disease is reviewed. Among patients with large left-to-right shunts the long-term prognosis for those with ASD and VSD is generally excellent. With rare exceptions, these patients can look forward to a normal adulthood. Residual atrioventricular valve disease complicates the long-term course of infants and children operated upon for atrioventricular canal, but nevertheless, most patients have remained stable for many years. Among patients after relief of right ventricular outflow tract obstruction, excellent documentation of long-term stability has been reported for children with valvular pulmonary stenosis, and most patients with tetralogy of Fallot appear to tolerate residual right ventricular outflow stenosis and insufficiency without serious complications. Dysrrhythmias occur, but severe sequelae are rare. The prognosis for survivors of pulmonary atresia with VSD is more guarded. Conduit longevity appears to be the most important concern, and long-term studies indicate that xenografts rarely last beyond a decade. The modern types of homografts cannot yet be evaluated on a long-term basis. For patients with pulmonary atresia and intact ventricular septum, there are a number of long-term survivors, but most have chronic right heart dysfunction with only a rare, outstanding result. The long-term outlook for patients with left ventricular outflow obstruction is guarded. Most patients after repair of aortic stenosis have residual aortic stenosis and/or insufficiency. Postaortic valvotomy adults tend to be symptom-free, despite residual disease, but almost certainly late management will be required.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term follow-up of operated congenital heart disease. 268 89

Flow patterns in the right heart are often difficult to visualize by color-coded Doppler flow imaging. The echogenicity of blood was increased in 48 patients by intravenous injection of 10 ml echovist (200 mg/ml), a saccharide solution with defined size and concentration of microbubbles. Its effect on improving color-coding was compared with the effect of agitated gelifundol (10 ml) in 21 patients with tricuspid valve regurgitation. The non-controlled size and concentration of microbubbles resulted in weaker or uncontrollably exaggerated color-coding in half of the patients. In eight normals biphasic atrial flow was visible only after injection of echovist. In 25 patients with tricuspid regurgitation the blue coded area of reflux was 25 +/- 21% of the atrial area from the parasternal approach and 10 +/- 9% from the apical approach without correlation of these results. After echovist the area of reflux was 57 +/- 31% (p less than 0.001) in the parasternal and 53 +/- 26% (p less than 0.001) in the apical approach (r = 0.83). This was paralleled by an increase of the severity of tricuspid regurgitation as defined by the length or area of reflux (p less than 0.01-0.001). The qualitative diagnosis was safely established in the five patients with VSD in the control color Doppler flow imaging, but only in three out of 10 patients with ASD, and in nine of 10 after injection of echovist. The intravenous injection of echovist, when using color-coded Doppler flow imaging for evaluation of right heart disease, facilitates the qualitative diagnosis of ASD and also of tricuspid regurgitation, particularly in the apical approach.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Contrast-color Doppler echocardiography. Improved right heart diagnosis following intravenous injection of Echovist]. 271 55

Total anomalous pulmonary venous connection (TAPVC) is a cardiac disorder that seldom permits survival into adulthood without surgical correction in infancy. We reported a successful total correction in a 47-year-old man with TAPVC. Cardiovascular angiography demonstrated the features of Darling I a type TAPVC. Cardiac catheterization showed Qp/Qs: 5.8, Pp/Ps: 0.31, Rp/Rs: 0.06 and mild pulmonary hypertension. On operation, the posterior wall of left atrium anastomosed to the common pulmonary vein over 4 cm length, ASD (5.0x3.8 cm) was closed with patch, and the communicating vein was ligated. The patient made uneventful postoperative recovery and is well 3 months following surgery.
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PMID:[Total anomalous pulmonary venous connection in adult: report of a case]. 277 53

Real-time two-dimensional Doppler echocardiography (2-D Doppler) is established as an effective diagnostic tool for cardiovascular diseases. However, in determining indications for surgery of congenital heart disease (CHD), the possibility of avoiding preoperative cardiac catheterization including radiographic angiography, has not been fully discussed since the clinical introduction of 2-D Doppler. We evaluated 278 patients with CHD by 2-D Doppler including ASDs (75 patients), VSD (76 patients), TOF (23 patients), TGA (12 patients), PDA (23 patients), ECD (13 patients), and 60 miscellaneous types of CHD during 27 months. The diagnosis of the 278 patients were confirmed by catheterization and/or surgery. Of these, 114 patients underwent corrective surgery (83 patients) or palliative procedures (31 patients). Preoperative cardiac catheterization was performed for 88 patients (Group A), and omitted in 26 patients (Group B). The 2-D Doppler diagnosis was correct in 79 patients of Group A (89.8%) and in 26 patients of Group B (100%). The surgical procedures scheduled according to the preoperative 2-D Doppler diagnosis were performed for these 105 patients (92.7%) without any corrections by cardiac catheterization diagnosis or by surgical findings. However, 2-D Doppler failed to establish the preoperative diagnosis for six patients in Group A (two patients with ASD, three with PDA, and one with TOF) and failed to detect associated cardiac abnormalities for three patients in Group A (two with PAPVC, one with Azygos connection). Results of this study suggest that preoperative cardiac catheterization could be omitted in a maximum of about 90% of surgical candidates with CHD. However, to omit cardiac catheterization 2-D Doppler echocardiographic criteria for indications for surgery in each group of CHD must be established, and any associated coronary artery abnormalities must be ruled out.
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PMID:[Color flow mapping 2-D Doppler in determining surgical indication for congenital heart disease]. 350 16

Magnetic resonance images were obtained in six patients with known or suspected interatrial septal defects (ASD) and 33 subjects without congenital heart disease. Image planes were oriented to the long and short axes of the left ventricle and septum and provided reproducible display of pertinent anatomic landmarks. Of the images in 33 control subjects, three (9%) were falsely positive showing apparent ASD. ASDs were correctly identified and localized in all six patients (five secundum, one primum). Long-axis views provided excellent display of the location and diameter of defects. All were confirmed at cardiac catheterization and four at surgery with good agreement in measurement of defect size and location. All showed signs of right-sided volume overload. Five had previous echocardiography, which showed definite or suspected ASD in four.
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PMID:Magnetic resonance imaging of the interatrial septum and atrial septal defects. 387 84

This study demonstrated the diagnostic usefulness of the newly-developed real-time two-dimensional Doppler echocardiography (2-D Doppler) in congenital heart disease. Among fifty-four patients with congenital heart disease, 18 had ASD; 16, VSD; 6, T/F; 3, PDA; 3, d-TGA; 3, ECD; and 1 each, DORV, PA, PS, Ebstein's anomaly, and ruptured aneurysm of the sinus of Valsalva. Each diagnosis was confirmed by cardiac catheterization and/or surgery. Forty normal cases were subjected as the control. The study cases included 26 adults and 28 children under 15 years old, 13 infants and seven newborns. In 52 cases (96.3%) 2-D Doppler provided diagnostic abnormal intracardiac blood flow images which were compatible with the data of cardiac catheterization and cardiac angiography and/or patients' cardiac anatomy observed during surgery. The blood flow data obtained by 2-D Doppler facilitated determining the appropriate timing of palliative surgery such as the Blalock-Taussig shunt procedure. 2-D Doppler was effective in evaluating medical (pharmaco-echocardiography) and surgical therapy including radical and palliative procedures for congenital heart disease. Thus, 2-D Doppler proved a non-invasive and useful diagnostic method for congenital heart heart disease. Our data suggest that with this technique cardiac surgery can be performed without cardiac catheterization or cardiac angiography in some cases of congenital heart disease.
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PMID:[Real-time two-dimensional Doppler echocardiography in congenital heart disease: its clinical significance]. 654 77

Serial sections of the atrioventricular (AV) conduction system were microscopically studied in 12 autopsied hearts: four with complete type common AV orifice (CAVO), two with atrial septal defect of the ostium primum type (ASD-I), two with ventricular septal defect of the persistent common AV canal type (VSD-C) and four without heart disease. The anatomic findings were semiquantitatively compared with the normal control using Feldt's method and correlated to the mean frontal QRS axis on ECG. The cases of CAVO or VSD-C with left axis devation invariably showed similar patterns regarding the location and course of the AV conduction system: (1) posterior displacement of the AV node, (2) relatively short distance between the AV node and the beginning of the left bundle branch (LBB), and (3) postero-inferior displacement of the bundle of His and the LBB. The postero-inferior displacement of the LBB seemed to be responsible for left axis deviation. The cases of ASD-I showed some additional findings: (1) impaired contiguity between the AV node and the bundle of His might have caused the occasional advanced AV block in one case, and (2) the posterior radiation of the LBB traversed down through the branch-free muscle bundle, which was assumed to be related to the right axis deviation in the other case. These findings suggest that the disposition of the AV conduction system in CAVO and in its related anomalies were basically the same whatever the type of defect, and this was considered to be correlated to the established ECG pattern.
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PMID:Histopathological correlation between the QRS axis and disposition of the atrioventricular conduction system in common atrioventricular orifice and in its related anomalies. 665 91

To investigate the right ventricular activation, filtered bipolar recordings (1 cm interelectrode distance) of Apex (RVA), Inflow tract (RVIT) and Outflow tract (RVOT) of the right ventricle were obtained in 4 groups of subjects. 1st group: 25 cases with normal QRS; 2nd group: 7 cases with left ventricular conduction disturbances (4 LBBB and 3 LAH patterns); 3rd group: 20 cases with chronic coronary heart disease (CCHD) and RBBB alone (5 cases) or combined with LAH (15 cases); 4th group: 9 young subjects without heart disease (7 cases) or ostium secundum atrial septal defect (2 cases) and RBBB pattern. The activation times were calculated from the beginning of the QRS in the first endocavitary rapid deflection. The data obtained (average +/- s.d.) for QRS duration (QRSd), RVA, RVIT and RVOT were respectively: 1st group: 97 +/- 9, 23 +/- 9, 36 +/- 9, 39 +/- 8; 2nd group: 133 +/- 43, 20 +/- 14, 25 +/- 9, 42 +/- 6; 3rd group: 152 +/- 12, 49 +/- 13, 61 +/- 18, 82 +/- 20; 4th group: 130 +/- 17, 39 +/- 12, 58 +/- 12, 55 +/- 27. Activation times as expected were similar in 1st and 2nd groups. Significant differences were noted between 1st and 3rd groups (p less than 0.001) in activation times of RVA, RVIT and RVOT. Between 1st and 4th group significant differences were noted in activation times of RVA and RVIT (p less than 0.001) while no significant differences were observed for RVOT (p greater than 0.05). In 2 cases of the third group (CCHD) and in the 2 cases of atrial septal defect the activation time of RVA was within the normal range suggesting a peripheral block. In the cases of the 3rd group with troncular RBBB activation times of RVIT and RVOT were significantly related to the QRSd (r = 0.79 and 0.65, p less than 0.001 and less than 0.01 respectively), while there was no significant correlation between the activation time of RVA and the QRSd. In accordance with other Authors our study demonstrates that: 1) the RBBB pattern in ASD has a peripheral electrogenesis; 2) the RBBB pattern in CCHD is generally due to a troncular block but our study also suggests the possibility of a distal block in these patients. In contrast with some Authors the RBBB pattern in young people without heart disease was due to a troncular and not to a peripheral block. Finally, the absence of correlation observed in the cases with troncular block of the 3rd group: 152 +/- 12, 49 +/- 13, 61 +/- 18, 82 +/- 20; 4th group: 130 +/- 17, 39 +/- 12, 58 +/- 12, 55 +/- 27. QRSd and RVIT and RVOT activation times might be explained as follows: 1) in high degree troncular block the RVA activation time is due to the time employed byt the wave front to cross the septum which is probably similar in all the cases; 2) the QRSd depends on the activation time of the peripheral areas which depends on the variable spread of activation of the right ventricle probably due to a variable participation of the specialized conduction system.
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PMID:[The right ventricular activation in ventricular activation delays. An endocardial mapping study (author's transl)]. 732 20


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