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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-one patients with polymyositis were prospectively examined with echocardiography, phonocardiography and electrocardiography. Cardiac performance, estimated with echocardiography, was enhanced as shown by a significant (P less than 0.01) increase in ejection phase indexes of left ventricular function compared with values in a matched control group. Known causes of the high output state, such as anemia or thyrotoxicosis, were not clinically evident. There was no evidence of left ventricular enlargement, left ventricular wall hypertrophy, or left atrial enlargement in the echocardiogram or chest X-ray film. The echocardiogram showed systolic mitral valve prolapse in 11 of 17 patients (65 percent) with an adequately imaged mitral valve; midsystolic clicks were present in 7 of these. One patient, who did not have prolapse, had echocardiographic evidence of a small pericardial effusion. Electrocardiographic abnormalities were present in 11 of 21 patients (52 percent) and included evidence of atrioventricular conduction disturbances, atrial and ventricular arrhythmias and left atrial abnormality. The pathophysiology of mitral valve prolapse and increased systolic left ventricular function in polymyositis remains uncertain; however, the spectrum of cardiac abnormalities, detected noninvasively in 16 of 21 of our patients (76 percent) may represent a high frequency rate of cardiac involvement in this disease.
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PMID:Cardiac manifestations in polymyositis. 66 23

New, poorly recognized echocardiographic findings were recorded in six patients with pericardial effusion. These findings were apparent prolapse of mitral and tricuspid valves, apparent systolic anterior motion of mitral valve, and midsystolic notching of pulmonic valve. Beat-to-beat variation of the dimensions of right and left ventricle and in the diastolic opening amplitude of the anterior mitral valve were present in cardiac tamponade. Substantial decrease or resolution of effusion resulted in disappearance of the observed abnormalities. Serial echographic studies before and after fluid resolution may prevent misleading echographic and clinical diagnoses.
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PMID:New, poorly recognized echocardiographic findings. Occurrence in patients with pericardial effusion. 98 57

Thirty-five consecutive patients with systemic lupus erythematosus were enrolled in a prospective study. Investigations included a physical evaluation, tests for antinuclear antibodies and antiphospholipid antibodies, an electrocardiogram, a plain chest film, a 2D echocardiogram and a Doppler study. Clinical cardiac manifestations and alterations of the electrocardiogram were infrequent (17% and 11% of patients, respectively) and no patients had abnormal chest film findings. In contrast, echocardiographic abnormalities were common (82% of patients), although moderate in most instances. Pericardial involvement was found in 15 patients (42.8%); a pericardial effusion was seen in 9 of the 14 patients with inactive disease (p < 0.003), whereas thickening of the pericardium was visible in 4 patients with active disease and 2 of the 21 patients with inactive disease. Valve abnormalities were found in 17 patients (48.5%), but were not related to the presence of antiphospholipid antibodies; valve alterations included verrucous endocarditis in one case, valve thickening in one case, mitral prolapse in five cases, and mild or moderate regurgitation in 15 cases (aortic in 2 cases, mitral in 7 cases, pulmonary in 3 cases and tricuspid in 7 cases). Alterations in ventricular chamber size and kinetics were also fairly common, albeit of uncertain pathogenetic significance. These data confirm the value of 2D echocardiography for identifying and monitoring cardiac involvement in systemic lupus erythematosus, even in patients with no overt clinical manifestations.
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PMID:[Evaluation of cardiac involvement in systemic lupus erythematosus. Clinical and echographic study]. 130 69

Fulminating active rheumatic carditis has been observed for over three decades in this environment with no recent alteration in either the incidence or the pattern of presentation. Heart failure (in this context defined as 'an inadequate circulation at rest together with a raised pulmonary venous pressure, with or without an associated high systemic venous pressure in the absence of haemodynamically significant tricuspid valve disease or pericardial effusion') is prevalent but occurs only when a haemodynamically important left-sided valve lesion supervenes. Regurgitation is the predominant valve lesion and involves principally the mitral valve. Mitral annular dilatation is marked and predisposes to lengthening--or rupture--of chordae tendineae and prolapse of the anterior leaflet. The resultant cardiac work-overload apparently perpetuates or aggravates the rheumatic activity. Heart failure, as defined, whether caused by or associated with active rheumatic carditis, makes surgical management of the valve lesion mandatory as a life-saving measure. Aggressive medical therapy for heart failure, which should include vasodilator drugs and especially angiotensin-converting enzyme inhibitors, provides temporary improvement only. Contrary to ongoing doctrine, treatment with steroid drugs in this context is neither life-saving nor beneficial.
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PMID:Mechanisms and management of heart failure in active rheumatic carditis. 220 Jan 47

In particular since the introduction of the two-dimensional approach, echocardiography as a non-invasive and easily repeatable bedside-technique without side-effects plays a central role within the diagnostic tools of cardiology. The following applications of cardiac ultrasound are commonly accepted and sufficiently validated: Assessment of the size of cardiac chambers including qualitative and quantitative evaluation of left ventricular function, detection of pericardial effusion, diagnosis of intra- and extracardiac tumors and thrombi, analysis of complex congenital diseases. Without the use of Doppler, valvular regurgitations can only be suspected by indirect parameters; in contrast, stenotic lesions as well as a variety of other valve abnormalities (calcifications/partial rupture/prolapse/vegetations) can be diagnosed with a high accuracy. Transesophageal echocardiography guarantees not only an optimal imaging quality in virtually all patients, in addition, the technique allows the routine visualization of the thoracic descending aorta and the left atrial appendage which is of importance for the diagnosis of aortic dissection and isolated left atrial appendage thrombi. Transesophageal echocardiography is also superior to the conventional precordial approach concerning the assessment of prosthetic valve malfunction (in particular in mitral position) and endocarditis-associated abscesses. Today, the echocardiographic visualization of coronary arteries is without clinical relevance.
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PMID:[The status of echocardiography within the scope of routine cardiologic diagnosis]. 269 44

Four cases of anorexia nervosa recently encountered were reported in respect to their cardiovascular manifestations including prolapse of the cardiac valves and other poorly recognized cardiac findings. All four patients, aged 13 to 32 years, were women and had marked emaciation (35 to 44% weight loss of the ideal body weight) with typical hormone abnormalities. Chest radiographs showed a small cardiac shadow, and sinus bradycardia with low voltage was present in their electrocardiograms. One case, 13-year-old, had a mid-systolic click and occasionally a late systolic murmur, and also an abdominal continuous hum. Echocardiography including two-dimensional color flow-mapping disclosed mitral valve prolapse in all, and tricuspid valve prolapse in two. Mild to moderate pericardial effusion was noted in all between the right ventricle and diaphragm, and pericardiocentesis in one case had no effect on the valve movements. No inflammatory changes were observed in the specimen of the pericardium and also of the fluid. An association of mitral valve prolapse and anerexia nervosa was discussed based on the previous studies, but the final conclusion remains unknown.
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PMID:[Association of anorexia nervosa and mitral valve prolapse]. 368 Oct 5

Fifty-three patients (34 who had diffuse scleroderma, and 19 who had CREST syndrome [calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasias]) were studied by noninvasive procedures, including resting electrocardiogram (ECG), continuous 24-hour Holter ECG monitoring, M-mode echocardiography, and 2-dimensional echocardiography. Only 22 patients (42%) had abnormalities such as conduction defects, supraventricular or ventricular arrhythmias, or ST-T changes detected on resting ECG. In contrast, using Holter monitoring, the number of conduction abnormalities seen increased from 10 to 16 patients and transient ST-T changes increased from 2 to 18 patients. Forty-eight patients had ventricular arrhythmias, with multiform ventricular premature beats in 21 (40%), pairs of runs of ventricular tachycardia in 15 patients (28%), and 1 or more runs of ventricular tachycardia in 7 (13%). Echocardiography detected asymmetric septal hypertrophy in 10 patients, impaired ventricular function in 9 patients, congestive cardiomyopathy in 2, mitral prolapse in 4, and pericardial effusion in 3 patients. Multiform and/or repetitive ventricular premature beats occurred more frequently in patients with echocardiographic abnormalities, but were also present in patients who had normal findings on echocardiographic examination. Cardiac involvement was not correlated with clinical variants of scleroderma (CREST syndrome or diffuse scleroderma), nor with other signs and symptoms of the disease. Thus, cardiac involvement is found much more frequently than would be expected from clinical symptoms or from results of resting ECG alone; therefore, Holter monitoring and echocardiography should be included in the routine workup of patients who have scleroderma.
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PMID:Noninvasive evaluation of cardiac dysrhythmias, and their relationship with multisystemic symptoms, in progressive systemic sclerosis patients. 406

We examined 39 patients with biopsy proven sarcoidosis of the lungs by one-dimensional, two-dimensional and pulsed Doppler echocardiography. In 18 (46.2%) we revealed a prolapse of one or both cusps of the mitral valve which can partly explain some of the complaints and objective findings in these patients (palpitations, chest pain, changes on ECG resembling myocardial infarctions, murmurs, etc.). A minor pericardial effusion was present in 8 (20.5%) of the patients. The finding of reduced systolic thickening and excursions of the interventricular septum in 4 (10.2%) may be related to the frequent prevalence of sarcoid granulomas in the septum. Asymmetric septal hypertrophy, recorded in 4 (10.2%) patients, may have had a similar origin. Administration of corticosteroids did not influence in a significant way any of the echocardiographic indicators nor the amount of pericardial effusion. In patients with palpitations and extrasystolic arrhythmias, however, the extrasystoles disappeared and the patients reported subjective relief in all instances.
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PMID:Echocardiography in sarcoidosis. 650 35

A 25-year-old quadriplegic man with mitral leaflet prolapse syndrome was seen for complaints of intermittent fever, chills, and cough of three months' duration. Subacute bacterial endocarditis was diagnosed. Unusual complications of this disorder included hyperplenism with pancytopenia, pericardial effusion, and multiple infections in the blood and the spleen. Antibiotic therapy was begun, and splenectomy was performed. After seven weeks of treatment, the patient was free of symptoms and was discharged with advice on appropriate antibiotic prophylaxis. We believe that although bacterial endocarditis is a major complication of mitral leaflet prolapse syndrome, it can be prevented with antibiotic prophylaxis whenever dental, surgical, or other invasive procedures are performed.
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PMID:Bacterial endocarditis in mitral leaflet prolapse syndrome. 707 Oct 31

Left atrial enlargement can usually be detected accurately using M mode echocardiography. However, in the presence of heart disease, asymmetric enlargement may lead to inaccurate assessment of left atrial size and shape. Pericardial effusion can usually be diagnosed on the basis of characteristic M mode echocardiographic findings. However, false positive patterns sometimes occur with the use of this single dimensional technique. Three patients with a greatly enlarged left atrium are described whose M mode echocardiogram suggested significant posterior pericardial fluid accumulation. In each patient, two dimensional echocardiography detected portions of a huge left atrium that prolapsed behind the left ventricular posterior wall and mimicked an isolated posterior pericardial effusion. In one case a right anterior oblique left ventricular cineangiogram suggested the presence of a ventricular septal defect or a false aneurysm of the left ventricle due to the prolapsed left atrium. Because two dimensional echocardiography can provide accurate spatial orientation with visualization of intracardiac structures in relation to one another in real time, it can identify the presence of left atrial prolapse and play an important role in the differential diagnosis of isolated echo-free spaces behind the left ventricle detected with M mode echocardiography.
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PMID:Prolapsed left atrium behind the left ventricular posterior wall: two dimensional echocardiographic and angiographic features. 746 4


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