Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To investigate the genesis of the third ( IIIs ) and fourth heart sounds (IVs), apical phonocardiograms were recorded simultaneously with pulsed Doppler signals of the mitral flow and interventricular septal (IVS) and left ventricular posterior wall (PW) echoes by M-mode echocardiography in 26 cases with the IIIs and 11 cases with the IVs. The following results were obtained: Cases with the IIIs were classified into the following three groups according to the time relationship between the IIIs and a rapid filling wave (D wave) of the mitral flow velocity pattern. IIIs -peak group: The IIIs occurred coincidently with the peak of the D wave in five healthy adolescents and in 12 cases with absolute left ventricular volume overload including mitral regurgitation (MR: eight cases), postoperative atrial septal defect (ASD: three cases) and ventricular septal defect (one case). IIIs -delay group: The IIIs occurred about 38 msec after the peak of the D wave in eight cases with relative left ventricular volume overload including congestive cardiomyopathy (CCM: three cases) and ischemic heart disease (IHD: five cases). IIIs -early phase group: The IIIs occurred about 35 msec before the peak of the D wave in a case with acute MR due to chordal rupture. In the IIIs -peak group, the IIIs coincided in time with the points of inflection (check points) of both the IVS and PW during rapid filling phase in three cases with MR of mild to moderate degree and one case of postoperative ASD. In the IIIs -delay group, the IIIs occurred simultaneously with either the check point of the IVS or PW in two cases with CCM and one case with IHD, and it occurred before the check points of both the IVS and PW in two cases with severe MR of IIIs -peak group and in a case with acute MR due to chordal rupture of IIIs -early phase group. Cases with the IVs were classified into following 2 groups according to the time relationship between the IVs and the atrial contraction wave (A wave) of the mitral flow velocity pattern. IVs-peak group: The IVs occurred coincidentally with the peak of the A wave in six cases with left ventricular hypertrophy including hypertrophic cardiomyopathy (five cases) and hypertension (one case). IVs-delay group: The IVs occurred about 33 msec after the peak of the A wave in five cases with left ventricular dilatation or dysfunction including old myocardial infarction (two cases), CCM (one case), postoperative ASD (one case) and aortic regurgitation (one case). There were two types of IVs in time relationship between the IVs and the check points of the left ventricular wall during atrial contraction phase.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Studies on the mechanisms of the third and fourth heart sounds: with special reference to the phase analysis of mitral flow velocity pattern]. 667 90

The patient was a 39-year-old man admitted with iterative severe chest distress and breathlessness associated with activity without chest complaint for eight years. In past, he was found to have cardiac murmur and was diagnosed congenital ASD at the time of his 25-year-old. Transthoracic two-dimensional echocardiography showed prominent trabeculations of right ventricle (Fig. 1). The right ventricular and atrium was dilated, right ventricular were hypokinetic and right ventricular function was impaired with an right ventricular area changes fraction of 26%. The left ventricular was not markedly dilated and its function was normal with a left ventricular ejection fraction of 63%. Long-term ASD results in right heart volume overload. Neuroendocrine adaptations also occur, with increased sympathetic activity and circulating catecholamines that result in increased contractility and heart rate. Shorter diastolic time due to tachycardia, increased intramyocardial tension from right ventricular dilatation, and increased myocardial oxygen demand, may result in subendocardial ischemia. The present case, therefore, could be regarded as acquired right ventricular HVM/NVM.
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PMID:A combination of right ventricular hypertrabeculation/noncompaction and atrial septal defect. 1923 13

Pulmonary arterial hypertension (PAH) is a rare and incurable disease, related to right ventricle overload and failure, which are late consequences of asymptomatic progressive pulmonary vascular occlusion. The clinical approach requires: a high clinical suspicion; the detection and confirmation of PAH by echo-Doppler and right heart catheterisation; identification of an etiology; assessment of functionality and life expectancy; and reversibility testing. We present the case of a 68-year-old male patient presenting with progressive fatigability and shortness of breath, abnormal heart beats in the last 4 years, aggravated in the last year. Clinical findings showed signs of cardiac failure. Multiple echocardiographies demonstrated right atrial and right ventricular dilatation, with severe PAH, subsequent severe pulmonary and tricuspid regurgitation, mild mitral and aortic regurgitation and efficient left ventricular function. Subsequent cardiac catheterization confirms severe PAH, excludes VSD, and sees a left-to-right shunt but an ASD could not be anatomically localized. Left ventricular function and the coronary arteries were normal. Transesophageal echocardiography demonstrated an ASD sinus venosus with bidirectional shunt associated with partial abnormal in pulmonary venous drainage, with right supranumery pulmonary vein with drainage in the sinus venosus, the upper and inferior right pulmonary veins flowing into the right atrium, the upper and inferior left pulmonary veins Bowing into the left atrium, associated to important superior and inferior vena cava dilatation. The patient receives treatment for right heart failure, oral anticoagulation, antiarrhythmic drugs, cardio-pulmonary rehabilitation is initiated and he is referred to a center specialised in PAH, for bosentan treatment. In this patient, it is surprising that even born with a potentially cyanogenic congenital heart disease, his condition is discovered at an advanced age on the edge for evolution towards an Eisenmenger Syndrome, being fairly asymptomatic until the last year when he receives treatment for left heart failure.
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PMID:[A rare cause of pulmonary arterial hypertension diagnosed in an elderly patient]. 2105 70