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

Carcinoid heart disease is a frequent complication of the carcinoid syndrome, usually presenting as right-sided valvular heart disease. Although the diagnosis is most often made with cardiac ultrasound, MRI and CT are valuable techniques for diagnosing carcinoid heart disease.
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PMID:MRI and CT revealing carcinoid heart disease. 1644 Feb 19

Over the last few years, the landscape of cardiovascular imaging has changed significantly. CT and MRI have emerged as robust imaging tools for diagnosing and characterizing a nearly exhaustive spectrum of cardiovascular diseases. With ECG-gating, advanced tomographic imaging techniques are available for imaging the beating heart and surrounding structures with unprecedented accuracy and precision. These new methods provide clinicians with substantial additional information, including--in the case of MRI--quantitative data on blood flow physiology and accurate measurements of ventricular volumes and function. Importantly, MRI has made recent dramatic strides in the evaluation of ischemic heart disease, and CT appears poised to provide an accurate alternative to catheter angiography in the anatomic assessment of obstructive coronary artery disease. The future of both of these modalities in the non-invasive evaluation of heart disease is bright.
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PMID:Evaluation of the cardiac surgery patient by MRI and CT imaging: the state of the art. 1651

Stroke is a rare disorder in childhood. The majority of these cases is of an ischemic nature. In spite of the long list of known causes, many strokes remain undetermined, so-called cryptogenic strokes. Increasing evidence indicates that, in the young adults, many cases of cryptogenic stroke are presumably due to paradoxical embolism. In childhood, this is usually not considered, unless in the context of a complex cyanotic heart disease. We present two cases, a 6-year-old boy and an 11-year-old girl who had an episode of cerebral ischemia documented by MRI, and in whom the only anomaly found was a patent foramen ovale (PFO) with intermittent left to right shunt at rest, but with a large right to left shunt during the Valsalva maneuvre. We assumed that, in our cases, in the absence of identifiable causes, the cerebral ischemia was most likely due to paradoxical embolism through the PFO. Of course, as in the adult, the paradoxical embolism could not be proved, but in our opinion it remains the most concrete possibility. Therefore, in presence of a cryptogenic stroke, a PFO should be investigated also in children.
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PMID:Cryptogenic stroke in children: possible role of patent foramen ovale. 1654 69

Recent technical improvements in CT and MRI scanners allow improved imaging of the heart and the coronary arteries. These methods will probably replace some of the traditional diagnostic methods: echocardiograms, nuclear medicine SPECT studies and invasive coronary angiograms. There are several established clinical applications for both CT and MRI. Their adoption, however, has been slow, mainly for two reasons: the technology has not been widely available, and the clinicians lack detailed knowledge about the diagnostic capabilities of each modality. In this paper the main applications of each modality are presented based on the inherent technical advantages. The main indications for cardiac CT are: calcium scoring, anomalies of the coronary arteries, assessment and quantification of arterial stenosis, stent patency evaluation, bypass surgery follow-up, myocardial bridging, pulmonary and cardiac veins assessment (for ablation), characterization of atheromatous plaques (soft, lipoid or calcified), assessment of the lungs, mediastinum and thorax. The main indications for cardiac MRI: functional evaluation of the left and right ventricle, assessment of myocardial viability by perfusion, grading of valvular disease, congenital heart disease diagnosis and post-surgical evaluation, cardiomyopathies, diagnosis of myocarditis, coarctation of the aorta, diagnosis of cardiac tumors and thrombi, and pulmonary veins evaluation. Based on the knowledge of each modality, advantages, performance and cost, the referring physician can use evidence based algorithms that will allow him/her to tailor the appropriate study for each clinical problem.
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PMID:[Cardiac imaging using MRI and CT]. 1659 18

For more than 20 years, interventional cardiac catheterization has considerably increased in the therapeutic management of simple congenital heart disease in childhood. It is possible to correct pulmonary or aortic valvar stenosis, to close a persistent shunt as patent arterial duct or atrial septal defect. Sometimes, it can replace surgical repair and can be proposed as a first line treatment. Interventional cardiac catheterisation has several advantages for the patient: no thoracotomy, no scar, shorter hospital stay, less painful, lower morbidity and reduced cost. These techniques have also benefited from miniaturization and evolution of the occluders with time. Gene therapy, tissue engineering and new imaging modality (MRI, endovascular echo) will be the future of interventional cardiac catheterization which will occupy a more important place in the treatment of congenital heart disease in children.
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PMID:[Transcatheter treatment of congenital heart disease]. 1670 20

The diagnosis of mitochondrial myopathy depends upon a constellation of findings, family history, type of muscle involvement, specific laboratory abnormalities, and the results of histological, pathobiochemical and genetic analysis. In the present paper, the authors describe the diagnostic approach to mitochondrial myopathies manifesting as extraocular muscle disease. The most common ocular manifestation of mitochondrial myopathy is progressive external ophthalmoplegia (PEO). To exclude myasthenia gravis, ocular myositis, thyroid associated orbitopathy, oculopharyngeal muscular dystrophy, and congenital fibrosis of the extraocular muscles in patients with an early onset or long-lasting very slowly progressive ptosis and external ophthalmoplegia, almost without any diplopia, and normal to mildly elevated serum creatine kinase and lactate, electromyography, nerve conduction studies and MRI of the orbits should be performed. A PEO phenotype forces one to look comprehensively for other multisystemic mitochondrial features (e.g., exercise induced weakness, encephalopathy, polyneuropathy, diabetes, heart disease). Thereafter, and presently even in familiar PEO, a diagnostic muscle biopsy should be taken. Histological and ultrastructural hallmarks are mitochondrial proliferations and structural abnormalities, lipid storage, ragged-red fibers, or cytochrome-C negative myofibers. In addition, Southern blotting may reveal the common deletion, or molecular analysis may verify specific mutations of distinct mitochondrial or nuclear genes.
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PMID:Extraocular mitochondrial myopathies and their differential diagnoses. 1676 Jan 17

Cardiac MRI (CMR) is replacing diagnostic cardiac catheterization as the modality of choice for anatomic and functional characterization of congenital heart disease (CHD) when echocardiographic imaging is insufficient. In this manuscript, we discuss the principles of anatomic imaging of CHD, placing emphasis on the appropriate choice and modification of pulse sequences necessary to evaluate infants and small children. Clinical examples are provided to illustrate the relative strengths and shortcomings of different CMR imaging techniques. Although cardiovascular function and flow techniques are not described, their role in evaluating the severity of anatomic defects is emphasized. Anatomic characterization represents the first component of a carefully-planned, integrated CMR assessment of CHD.
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PMID:Anatomical assessment of congenital heart disease. 1686 12

A temporal correlation (TC) mapping method is proposed to help bolus chasing during dynamic contrast-enhanced (DCE) MRI of complex pulmonary circulation (CPC) in patients with congenital heart disease. DCE-MRI was performed on five healthy male subjects (23-24 years old) and 25 patients (nine males and 16 females, 0.25-44 years old), and TC maps were generated by performing pixel-based computation of cross-correlations to the pulmonary artery with a series of time shifts in all subjects. Qualitative and quantitative evaluations were performed in comparison with original DCE images. TC maps exhibited a better signal-to-noise ratio (SNR) by factors of 4.3 and 1.3 in the lung parenchyma, pulmonary veins, and superior artery/vein; a better intraparenchymal contrast-to-noise ratio (CNR) by factors of 1.5-5.4; and a significantly higher conspicuity in all regions except the pulmonary arteries when graded with a five-point score. TC maps evaluated by two experienced clinicians significantly added relevant information (P<0.001), and in some cases affected the final diagnosis. We conclude that TC maps facilitate bolus chasing for DCE-MRI by reducing recirculation effects and interframe fluctuations, and hence complements morphological imaging of CPC in patients with complex congenital heart disease.
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PMID:Temporal correlation-based dynamic contrast-enhanced MR imaging improves assessment of complex pulmonary circulation in congenital heart disease. 1690 78

Minimally invasive cardiac surgery requires arresting and emptying of the heart, which compromises visualization of the surgical field. In this feasibility study a novel surgical procedure is demonstrated in which real-time MRI is used to guide the placement of a prosthetic aortic valve in the beating heart via direct apical access in eight porcine hearts. A clinical stentless bioprosthetic valve affixed to a platinum stent was compressed onto a balloon-tipped catheter. This was fed through a 15-18-mm delivery port inserted into the left ventricular (LV) apex via a minimally invasive subxyphoid incision. Using interactive real-time MRI, the surgeon implanted the prosthetic valve in the correct location at the aortic annulus within 90 s. In four of the animals immediately after implantation, ventricular function, blood flow through the valve, and myocardial perfusion were evaluated with MRI. MRI-guided beating-heart surgery may provide patients with a less morbid and more durable solution to structural heart disease.
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PMID:Real-time interactive MRI-guided cardiac surgery: aortic valve replacement using a direct apical approach. 1703

The role of heart catheterization continues to evolve as the sophistication of cardiac MRI and CT improves and the breadth of interventional catheter techniques widens. This analysis is approached from four perspectives: (1) planning of the procedure, including information required, potential pitfalls, and equipment; (2) performance of the procedure, including sample run, coronary arteriography, chamber angiography, and angiography of selected lesions; (3) current role of heart catheterization, considering the impact of echo, MRI, and CT on indications for catheterization procedures and current interventional procedures; and (4) new and emerging interventions and speculation as to the future role of diagnostic heart catheterization in patients who have adult congenital heart disease.
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PMID:The role of cardiac catheterization in adult congenital heart disease. 1709 10


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