ABSTRACT
Bicuspid aortic valve (BAV) is a common congenital cardiac anomaly, and rarely, it is associated with sinus of Valsalva aneurysms (SOVAs). And very infrequently, these SOVAs rupture into left side of heart. We hereby report a case of 12-year-old male with BAV with severe aortic stenosis with a large SOVA that ruptured into the left side of the heart. The anatomy was delineated with multimodality imaging; initially with two-dimensional trans-thoracic echocardiography (TTE), and later on with three-dimensional TTE and with multi detector computed tomography. Operative interventions were planned for the patient.
Subject(s)
Aortic Rupture/etiology , Aortic Valve Stenosis/complications , Aortic Valve/abnormalities , Heart Valve Diseases/complications , Sinus of Valsalva/diagnostic imaging , Aortic Rupture/diagnostic imaging , Aortic Valve Stenosis/diagnostic imaging , Bicuspid Aortic Valve Disease , Child , Echocardiography , Fatal Outcome , Humans , Male , Tomography, X-Ray ComputedSubject(s)
Kearns-Sayre Syndrome/diagnosis , Adult , Diagnosis, Differential , Electrocardiography , Humans , MaleABSTRACT
BACKGROUND: There is a paucity of data from large cohort studies examining the prognostic significance of obstructive sleep apnea (OSA) in patients with coronary artery disease. We hypothesized that OSA predicts subsequent major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing percutaneous coronary intervention. METHODS AND RESULTS: The Sleep and Stent Study was a prospective, multicenter registry of patients successfully treated with percutaneous coronary intervention in 5 countries. Between December 2011 and April 2014, 1748 eligible patients were prospectively enrolled. The 1311 patients who completed a sleep study within 7 days of percutaneous coronary intervention formed the cohort for this analysis. Drug-eluting stents were used in 80.1% and bioresorbable vascular scaffolds in 6.3% of the patients, and OSA, defined as an apnea-hypopnea index of ≥15 events per hour, was found in 45.3%. MACCEs, a composite of cardiovascular mortality, nonfatal myocardial infarction, nonfatal stroke, and unplanned revascularization, occurred in 141 patients during the median follow-up of 1.9 years (interquartile range, 0.8 years). The crude incidence of an MACCEs was higher in the OSA than the non-OSA group (3-year estimate, 18.9% versus 14.0%; p=0.001). Multivariate Cox regression analysis indicated that OSA was a predictor of MACCEs, with an adjusted hazard ratio of 1.57 (95% confidence interval, 1.10-2.24; P=0.013), independently of age, sex, ethnicity, body mass index, diabetes mellitus, and hypertension. CONCLUSIONS: OSA is independently associated with subsequent MACCEs in patients undergoing percutaneous coronary intervention. Evaluation of therapeutic approaches to mitigate OSA-associated risk is warranted. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01306526.
Subject(s)
Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/surgery , Percutaneous Coronary Intervention/trends , Sleep Apnea, Obstructive/epidemiology , Sleep Apnea, Obstructive/surgery , Aged , Cardiovascular Diseases/diagnosis , Cohort Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Percutaneous Coronary Intervention/adverse effects , Prospective Studies , Registries , Risk Factors , Sleep Apnea, Obstructive/diagnosisABSTRACT
Double-chambered right ventricle (DCRV) is a rare congenital anomaly in which the right ventricle is divided into two compartments with varying pressures due to an anomalous muscle bundle. Here, we describe a case of an adolescent male with DCRV with associated ventricular septal defect and subaortic membrane. Two-dimensional and three-dimensional transthoracic echocardiography with color flow clearly outlined all the three cardiac anomalies as well as their relationship with each other. The diagnosis was confirmed by cardiac catheterization. The patient underwent successful surgical resection of the anomalous muscle bundle along with repair of the associated anomalies.
Subject(s)
Echocardiography, Three-Dimensional , Heart Septal Defects, Ventricular/diagnostic imaging , Heart Ventricles/abnormalities , Heart Ventricles/diagnostic imaging , Child , Heart Septal Defects, Ventricular/complications , Heart Septal Defects, Ventricular/surgery , Heart Ventricles/surgery , Humans , Male , Treatment OutcomeSubject(s)
Aorta/abnormalities , Echocardiography, Doppler , Heart Aneurysm/diagnostic imaging , Heart Ventricles/abnormalities , Multidetector Computed Tomography , Adult , Aorta/diagnostic imaging , Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Insufficiency/etiology , Aortography , Bradycardia/etiology , Calcinosis/diagnostic imaging , Calcinosis/etiology , Cardiomyopathies/diagnostic imaging , Heart Aneurysm/complications , Heart Aneurysm/pathology , Heart Block/etiology , Heart Septum/diagnostic imaging , Heart Ventricles/diagnostic imaging , Humans , Male , Marfan Syndrome/pathology , Pacemaker, Artificial , Pulmonary Valve Stenosis/diagnostic imaging , Pulmonary Valve Stenosis/etiology , Syncope/etiology , Ventricular Outflow Obstruction/diagnostic imaging , Ventricular Outflow Obstruction/etiologyABSTRACT
A 20 year old female was referred to us for evaluation of effort dyspnoea of NYHA class II with feeble left common carotid, left brachial and left radial artery as compared to other sides. Detail evaluation with two dimensional (2D) transthoracic echocardiographic, 2D transesophageal echocardiography and multidetector computed tomography (MDCT) delineated Cleft AML and diffuse type of supravalvular aortic stenosis. To the best of our knowledge, no such case have been described in the literature where these anomalies co-existed in the same patient.
ABSTRACT
Peripartum cardiomyopathy is a cardiac condition characterized by development of heart failure during the last month of pregnancy or during the first five months of post partum period without any other identifiable cause of heart failure. The hypercoagulable state in the pregnancy along with left ventricular (LV) systolic dysfunction predisposes the patient to thromboembolic complications like intraventricular thrombi. We report a case of a 30-year-old female with peripartum cardiomyopathy along with a highly mobile mass in the LV cavity on two dimensional echocardiography. Three dimensional transthoracic echocardiography clearly showed the pedicle of the mass attached to the interventricular septum along with internal echolucent areas within the mass. Due to denial of the patient to undergo surgery, she was started on oral anticoagulation, with complete dissolution of the mass within one month.
ABSTRACT
Ruptured aneurysm of the anterior mitral leaflet is a rare but a devastating complication secondary to aortic valve infective endocarditis. We report a case of 30-year-old male with native aortic valve endocarditis who was referred to us for evaluation of worsening of heart failure after an initial period of responsiveness to antibiotics. Detailed evaluation with two-dimensional and three-dimensional transthoracic echocardiography revealed ruptured anterior mitral leaflet aneurysm with severe eccentric mitral regurgitation along with a large vegetation on the aortic valve. The patient underwent successful surgical closure of the defect along with aortic valve replacement.
Subject(s)
Aneurysm, Ruptured/diagnostic imaging , Echocardiography, Three-Dimensional/methods , Endocarditis, Bacterial/complications , Heart Aneurysm/diagnostic imaging , Heart Valve Prosthesis Implantation/methods , Mitral Valve Insufficiency/diagnostic imaging , Adult , Aneurysm, Ruptured/etiology , Aneurysm, Ruptured/surgery , Aortic Valve/microbiology , Aortic Valve/pathology , Bioprosthesis , Cardiac Surgical Procedures/methods , Echocardiography, Doppler, Color/methods , Endocarditis, Bacterial/diagnostic imaging , Follow-Up Studies , Heart Aneurysm/etiology , Heart Aneurysm/surgery , Heart Failure/diagnosis , Heart Failure/etiology , Humans , Male , Mitral Valve/diagnostic imaging , Mitral Valve/surgery , Mitral Valve Insufficiency/etiology , Mitral Valve Insufficiency/surgery , Rare Diseases , Risk Assessment , Severity of Illness Index , Streptococcal Infections/complications , Streptococcal Infections/diagnostic imaging , Treatment OutcomeSubject(s)
Cardiomyopathy, Dilated/etiology , Inferior Wall Myocardial Infarction/etiology , Takayasu Arteritis/complications , Cardiomyopathy, Dilated/diagnosis , Coronary Angiography , Diagnosis, Differential , Echocardiography , Humans , Inferior Wall Myocardial Infarction/diagnosis , Male , Multidetector Computed Tomography , Takayasu Arteritis/diagnosis , Young AdultSubject(s)
Angina, Unstable/etiology , Echocardiography/methods , Heart Aneurysm/diagnosis , Heart Ventricles , Multidetector Computed Tomography/methods , Ventricular Outflow Obstruction/diagnosis , Adult , Angina, Unstable/diagnosis , Cardiac Surgical Procedures/methods , Coronary Angiography , Diagnosis, Differential , Electrocardiography , Heart Aneurysm/complications , Heart Aneurysm/surgery , Humans , Male , Severity of Illness Index , Ventricular Outflow Obstruction/etiology , Ventricular Outflow Obstruction/surgerySubject(s)
Aortic Valve/abnormalities , Echocardiography, Three-Dimensional/methods , Heart Valve Diseases/diagnostic imaging , Mitral Valve/diagnostic imaging , Adolescent , Aortic Valve/ultrastructure , Bicuspid Aortic Valve Disease , Diagnosis, Differential , Humans , Male , Mitral Valve/abnormalitiesSubject(s)
Abnormalities, Multiple/diagnosis , Heart Defects, Congenital/diagnosis , Heart Ventricles/abnormalities , Mitral Valve/abnormalities , Multimodal Imaging/methods , Abnormalities, Multiple/surgery , Child , Echocardiography/methods , Echocardiography, Doppler, Color/methods , Echocardiography, Three-Dimensional/methods , Heart Defects, Congenital/surgery , Humans , Male , Mitral Valve/diagnostic imaging , Multidetector Computed Tomography/methods , Sensitivity and SpecificityABSTRACT
Submitral left ventricular aneurysms are a rare nonischemic aneurysm thought to be developmental in origin. These aneurysms invariably occur at the site of posterior mitral annulus and lead to mitral valve incompetence. We hereby describe a case of a 30-year-old adult with a rare form of submitral left ventricular aneurysm involving whole of the posterior mitral annulus. Multimodality imaging with two-dimensional echocardiography, three-dimensional echocardiography, computed tomography and invasive left ventriculography helped the patient to undergo successful resection of the aneurysm along with mitral valve replacement.