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

Twenty-six patients with Wolff-Parkinson-White (WPW) syndrome were studied by echocardiography. They were classified into the following WPW types: anterior right ventricular pre-excitation (Type I) - six patients; posterior right ventricular pre-excitation (Type II) - six patients; posterior left ventricular pre-excitation (Type III) - fourteen patients. Twenty-three patients were in WPW at the time of study. Four patients with Type I WPW had abnormal systolic motion of the interventricular septum: three paradoxical and one flat. Patients with Type II and Type III WPW had no septal motion abnormalities related to pre-excitation. Three patients had intermittent WPW, Type III; in all three only minor changes in normal septal motion were apparent on WPW beats. Associated cardiac abnormalities were evident in six patients: two mitral prolapse (one Type II WPS and one Tpe III); one idiopathic hypertrophic subaortic stenosis (Type III); one congestive cardiomyopathy (Type III); one hypertrophic nonobstructive cardiomyopathy (Type I); and one atrial septal defect (Type II). We conclude that abnormal interventricular septal motion may occur with Type I WPW abnormality. Other abnormalities are detectable by echocardiography in a high proportion of WPW patients, but do not appear to be associated with any single Wolff-Parkinson-White type.
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PMID:Echocardiography in Wolff-Parkinson-White syndrome. 13 57

Nine adult patients with large pericardial effusions (PE) demonstrated echocardiographic motion abnormalites of cardiac valves in systole. In four cases (Group 1), the abnormal findings consisted of prominent systolic anterior movements of the mitral valve resembling those seen in idiopathic hypertrophic subaortic stenosis. In Group 2(five cases), typical mitral valve prolapse patterns with large posterior midsystolic displacements well below the C point were observed. Additional abnormalities in Group 2 included tricuspid valve prolapse patterns (four cases), early systolic movement of the aortic valve toward closure (three cases), midsystolic notching of the pulmonary valve (two cases) and abnormal or attenuated motion of the aortic root in all patients. Marked decrease or resolution of PE resulted in complete disappearance of all the observed abnormalities. These findings appeared to be related to large fluid collections behind the left atrium and abnormal movement of the heart in the pericardial space. In the presence of PE, therefore, the echocardiographic observation of abnormal valve motion may not be clinically significant.
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PMID:Echocardiography of cardiac valves in pericardial effusion. 94 81

Systolic anterior motion of the mitral valve with left ventricular outflow tract obstruction after Carpentier-type mitral reconstruction with ring annuloplasty has led some surgeons to abandon an otherwise successful repair or to avoid use of a rigid ring. To assess the long-term significance of such motion, we studied 439 patients undergoing Carpenter mitral reconstruction at our institution between March 1981 and June 1990. The hospital mortality rate was 4.8% (21/439) overall and 3.7% (9/243) for isolated mitral reconstruction. Systolic anterior motion was found in 6.4% (28/438) after the operation, and 2.3% (10/438) had a coexisting left ventricular outflow tract gradient (mean 53 mm Hg). Of the 28 patients with systolic anterior motion, 27 (96.4%) had leaflet prolapse, 17 (60.7%) had undergone more than a 3 cm resection of the posterior leaflet, and two (7.1%) had preexisting idiopathic hypertrophic subaortic stenosis. All patients were treated medically, 14 with negative inotropic agents. Follow-up echocardiograms at a mean of 32 months demonstrated the disappearance of systolic anterior motion in 13 of 28 patients (46.4%) and resolution of the outflow tract gradient in 10 of 10 (100%). At follow-up only one patient was in New York Heart Association class III or IV and required reoperation for rheumatic mitral insufficiency. These data demonstrate that systolic anterior motion after Carpentier mitral reconstruction with ring annuloplasty is not prevalent and should be managed medically in most cases. Associated left ventricular outflow tract obstruction resolves with medical treatment.
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PMID:Experience with twenty-eight cases of systolic anterior motion after mitral valve reconstruction by the Carpentier technique. 154 45

In emergency surgery, the essential prerequisites for success are speed, promptitude and precision. For this reason diagnosis must be equally prompt and precise and may require not only clinical examination but also a number of instrumental examinations designed to confirm or even to formulate the diagnosis which is usually the case in precordialgias of cardiovascular origin. In such syndromes ultrasound cardiography is particularly advantageous for the following reasons: it is non-invasive, provides immediate results and any number of examinations can be performed on the patient in bed. Since such ultrasound techniques are also reliably accurate, they constitute the method of choice when the patient's condition is critical, when a serial study of a single patient is required and when the results are required immediately, as is the case in emergency heart surgery. Four types of ultrasound cardiography are currently available for the diagnosis of precordialgias of cardiovascular origin: 1) one dimensional M-mode echocardiography; 2) two dimensional real time echocardiography; 3) Doppler ultrasound cardiography; 4) the echo-Doppler system in which Doppler ultrasound cardiography is combined with one or two dimensional echocardiography. Acute precordial pain of cardiovascular origin may be due to the following pathological conditions: 1) ischaemic cardiopathy especially acute myocardial infarction and transitory myocardial ischaemia; 2) acute pericarditis; 3) aortic stenosis; 4) idiopathic hypertrophic subaortic stenosis; 5) mitral prolapse; 6) dissecting aneurysm of the aorta; 7) pulmonary thromboembolism. In all these cases the single and two dimensional image and Doppler ultrasound cardiography provide highly sensitive and specific information that is, in some cases, decisive for diagnosis and in others confirms the diagnosis already formulated. In addition these techniques may provide valuable prognostic data. Ultrasound cardiography is indeed useful in all cardiological emergencies, such as those caused by cardiomegaly, new and developing murmurs, peripheral embolisms, cardiac traumas and arrhythmias. It is therefore suggested that every Emergency and Intensive Care Unit should be able to use the resources offered by ultrasound cardiography in diagnosis.
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PMID:[Emergency ultrasound cardiography in acute precordial pain of cardiovascular origin]. 362 31

A clinico-pathologic study was performed in 25 patients undergoing aortic valve replacement because of regurgitation, caused by myxoid degeneration of the valve leaflets. Associated cardiac anomalies were floppy mitral valve (2 cases), floppy mitral valve and idiopathic hypertrophic subaortic stenosis (1), left atrial myxoma (1), and aortic coarctation at the isthmus (1). Three patients died (2 immediately and 1 on the 30th postoperative day). Pathological studies of the explanted valves showed deformities characterized by redundant thin leaflets which appeared soft and gelatinous. On histologic examination the fibrous layer of the leaflets was seen to be infiltrated by myxomatous tissue. Echocardiography showed the aortic root to be dilated in 13 patients and normal in the others. In those with normal aortic root, the histological examination of aortic wall disclosed minimal cystic medial necrosis in two cases. In contrast, more severe forms of cystic medial necrosis were evident in all patients having a dilated aortic root. Aortic valve replacement was performed in all cases. It was accompanied by a Bentall procedure (1 case), repair of ascending aorta dissection (2), replacement of the ascending aorta (1), mitral valve replacement (2), mitral valve replacement and apico-ascending aorta conduit (1) and excision of a left atrial myxoma (1). Our experience suggests that prolapse of the aortic valve due to floppy leaflets is a common degenerative disease which is generally associated with noninflammatory aortic root degeneration. This, together with aortic root dilatation, contributes to valve insufficiency. Nevertheless, the disease, when isolated (with normal aortic root), is liable in itself to produce aortic regurgitation. The need for early diagnosis is stressed, so as to be able to perform valve replacement.
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PMID:Prolapse of the "floppy" aortic valve as a cause of aortic regurgitation. A clinico-morphologic study. 407 99