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1.
J Am Coll Cardiol ; 2(6): 1219-23, 1983 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-6630792

RESUMO

M-mode, two-dimensional and Doppler echocardiography were used to assess the comparative value of each in the detection of clinically diagnosed mitral valve prolapse; 125 consecutive patients with a mid- to late systolic click, with or without a late systolic murmur, were included. There were 46 men and 79 women; their mean age was 42 years. M-mode echocardiography detected 62 of 125 cases (sensitivity 50%). Two-dimensional echocardiography was positive in 85 cases (sensitivity 68%) and 90 cases were detected with Doppler echocardiography (sensitivity 72%). When all three techniques were combined, 116 cases were correctly diagnosed (total echographic sensitivity 93%). The relative insensitivity of the M-mode technique and the additive value of two-dimensional and Doppler echocardiography in the detection of auscultatory mitral prolapse are emphasized.


Assuntos
Ecocardiografia/métodos , Prolapso da Valva Mitral/diagnóstico , Adolescente , Adulto , Idoso , Efeito Doppler , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
2.
Am J Med ; 60(5): 677-86, 1976 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-139105

RESUMO

Echocardiography is an extremely useful noninvasive technic in the differential diagnosis of a large heart. It may show whether a large heart is due to left ventricular hypertrophy or dilatation, or if it is due to a pericardial effusion. The hypertrophied heart may be further characterized by determining whether it is symmetrical, as caused by aortic stenosis or hypertension, or whether it is assymmetrical, which is characteristic of hypertrophic cardiomyopathy. Similarly, dilatation of the heart may be due to volume overload of the left ventricle secondary to valvular insufficiency, congestive cardiomyopathy or ischemic heart disease; these can be distinguished by echocardiography. As certain types of mitral insufficiency are associated with specific valvular dysfunction, the possible etiology of the mitral insufficiency and therefore of the volume overload of the left ventricle may be determined using echocardiography. Finally, mediastinal tumors may simulate a large heart, and demonstration of normal cardiac dimensions and wall motion can exclude a cardiac etiology for the "large heart."


Assuntos
Cardiomegalia/diagnóstico , Ecocardiografia , Adulto , Idoso , Estenose da Valva Aórtica/complicações , Cardiomegalia/etiologia , Doença das Coronárias/complicações , Diagnóstico Diferencial , Feminino , Insuficiência Cardíaca/complicações , Humanos , Hipertensão/complicações , Neoplasias do Mediastino/diagnóstico , Insuficiência da Valva Mitral/complicações , Derrame Pericárdico/diagnóstico
3.
Am J Cardiol ; 44(7): 1391-5, 1979 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-506942

RESUMO

In six patients with clinically significant amyloid infiltrative cardiomyopathy, echocardiographic right ventricular anterior wall thickness was significantly increased (mean 7.5 +/- 2.3 mm; range 5 to 10 mm). This finding in conjunction with the previously described abnormalities of the left ventricle (symmetric increase in wall thickness, diffuse hypokinesia, and small to normal left ventricular diastolic dimension) is consistent with the findings of a diffuse myocardial infiltrative process and should minimize confusion with constrictive pericarditis.


Assuntos
Amiloidose/complicações , Cardiomiopatias/complicações , Ecocardiografia , Adulto , Idoso , Amiloidose/patologia , Cardiomiopatias/patologia , Feminino , Ventrículos do Coração/fisiopatologia , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Pericardite Constritiva/complicações
4.
Am J Cardiol ; 49(2): 339-43, 1982 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-7058750

RESUMO

Detection and estimation of the degree of chronic aortic insufficiency with pulsed Doppler echocardiography was attempted in 27 patients documented to have aortic insufficiency on aortography. Twenty-five patients had associated aortic stenosis or mitral valve disease, or both. A disturbed diastolic flow within the left ventricular outflow tract was recorded in all but one patient (Doppler sensitivity 96 percent). Aortic insufficiency was clinically undetected in three patients (clinical sensitivity 89 percent). In a small number of patients Doppler echocardiography also appeared to be highly specific for this disorder. The Doppler technique estimated the degree of aortic insufficiency by assessing the distribution of diastolic flow within the outflow tract and the body of the left ventricle. A significant correlation between the Doppler method and the angiographic estimation of aortic insufficiency was found (r = 0.88, p less than 0.01).


Assuntos
Insuficiência da Valva Aórtica/diagnóstico , Ecocardiografia/métodos , Adulto , Idoso , Insuficiência da Valva Aórtica/complicações , Insuficiência da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/diagnóstico , Estenose da Valva Aórtica/diagnóstico por imagem , Aortografia , Diástole , Efeito Doppler , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estenose da Valva Mitral/complicações , Estenose da Valva Mitral/diagnóstico , Estenose da Valva Mitral/diagnóstico por imagem
5.
Am J Cardiol ; 44(7): 1383-90, 1979 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-506941

RESUMO

Seventeen patients with accepted M mode echocardiographic criteria for flail mitral leaflet were studied. M mode echocardiograms revealed characteristic disordered mitral valve motion: (1) 16 (94 percent) had chaotic diastolic mitral motion; (2) 14 (82 percent) had systolic mitral flutter; (3) 14 (82 percent) had systolic left atrial echoes; and (4) 12 (71 percent) had systolic mitral valve prolapse. In 8 patients (47 percent) all four findings were present, with three findings present in 16 (35 percent) and two findings present in 13 (18 percent); none had fewer than two findings. Cross-sectional echocardiographic studies in 10 patients revealed a systolic whipping motion of the posterior mitral leaflet into the left atrium in all, abnormal systolic mitral coaptation in all and an abnormal mass of systolic left atrial echoes in 4. None of the first three M mode criteria were observed in 230 patients with uncomplicated "mid systolic click-late systolic murmur" syndrome; cross-sectional echocardiography in 30 of 230 patients revealed normal systolic mitral coaptation and no systolic whipping of the tip of the posterior mitral leaflet into the left atrium.


Assuntos
Ecocardiografia , Insuficiência da Valva Mitral/diagnóstico , Adolescente , Adulto , Idoso , Diástole , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/etiologia , Prolapso da Valva Mitral/diagnóstico , Sístole
6.
Chest ; 74(5): 548-51, 1978 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-153829

RESUMO

Echocardiographic studies were performed in 23 hypertensive patients who were receiving therapy with long-term hemodialysis. Five patients (22 percent) had normal thickness of the left ventricular wall. Eleven (48 percent) had symmetric left ventricular hypertrophy, and seven (30 percent) showed asymmetric septal hypertrophy, with a ratio of septal to posterior wall thickness of 1.3 or greater. The latter group differed from patients with hypertrophic cardiomyopathy in that patients on long-term hemodialysis had a dilated left ventricular dimension, a relatively normal diastolic slope of the mitral valve, absence of systolic motion of the mitral valve, and a septal to posterior wall ratio of less than 1.5. A high incidence of asymmetric septal hypertrophy in this and other studies indicates that this condition is not specific for hypertrophic cardiomyopathy. We suggest that in addition to asymmetric septal hypertrophy, the diagnosis of hypertrophic cardiomyopathy should be made in the light of the clinical picture, as well as other echocardiographic features.


Assuntos
Cardiomegalia/diagnóstico , Cardiomiopatias/diagnóstico , Septos Cardíacos , Diálise Renal , Adulto , Cardiomegalia/etiologia , Diagnóstico Diferencial , Ecocardiografia , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Diálise Renal/efeitos adversos , Fatores de Tempo
7.
Chest ; 67(1): 108-10, 1975 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1235312

RESUMO

Three cases of mediastinal tumors (thymic cyst, fibrosarcoma, fibrolipoma) mimicking primary cardiac disease were studied by echocardiography. The echocardiographic findings of the thymic cyst are presented and the echocardiograms in the other two patients discussed. Intrinsic cardiac pathology was excluded and discovery of abnormal extracardiac echoes prompted further investigation. In each instance, the echocardiographic interpretation of the nature and position of each extracardiac mass was confirmed by surgery or autopsy. We conclude that echocardiography is a useful noninvasive technique in differentiating between cardiac and extracardiac disease, and should be performed whenever an unusual or enlarged cardiac silhouette is encountered.


Assuntos
Cardiomiopatias/diagnóstico , Ecocardiografia , Neoplasias do Mediastino/diagnóstico , Idoso , Cistos/diagnóstico , Diagnóstico Diferencial , Humanos , Lipoma/diagnóstico , Lipossarcoma/diagnóstico , Doenças Linfáticas/diagnóstico , Masculino , Timo
8.
Chest ; 89(1): 154-5, 1986 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3940778

RESUMO

Two cases with chest compression-induced thoracolumbar transvertebral fractures are discussed. This is a previously unreported complication of cardiopulmonary resuscitation. Dorsal kyphosis and osteopenia were present in both of these cases. There was no spinal cord injury documented, though the potential for injury and paraplegia exists. Care should be taken to avoid this complication, especially in the elderly with kyphosis; however, adequate compressions to insure support of circulation should be maintained.


Assuntos
Fraturas Ósseas/etiologia , Ressuscitação/efeitos adversos , Traumatismos da Coluna Vertebral/etiologia , Idoso , Feminino , Humanos , Masculino , Métodos , Pressão
9.
Chest ; 70(6): 726-31, 1976 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-1001049

RESUMO

Echocardiography has been useful in the evaluation of congestive and hypertrophic cardiomyopathies. We present echocardiographic findings in seven patients with infiltrative cardiomyopathy due to amyloid. Cardiac amyloidosis was documented at autopsy in two patients, and the diagnosis was suggested by clinical, echocardiographic, tissue, or hemodynamic findings in the other five. Hemodynamic findings in three patients mimicked constrictive pericarditis; and autopsy was performed on one of the three and showed a normal pericardium. Underlying disorders were multiple myeloma (five patients), ankylosing spondylitis (one patient), and an unknown disorder (one patient). The basic echocardiographic findings in infiltrative cardiomyopathy due to amyloid were (1) symmetrically increased left ventricular wall thickness (in the absence of hypertension or aortic valvular disease), (2) hypokinesia and decreased systolic thickening of the interventricular septum and left ventricular posterior wall, and (3) small to normal size of the left ventricular cavity. Two patients also had small pericardial effusions. Thus, in a patient with congestive heart failure, these echocardiographic findings should suggest infiltrative cardiomyopathy.


Assuntos
Amiloidose/complicações , Cardiomiopatias/diagnóstico , Idoso , Cardiomiopatias/etiologia , Diagnóstico Diferencial , Ecocardiografia , Feminino , Insuficiência Cardíaca/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia
10.
Chest ; 72(1): 20-6, 1977 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-326498

RESUMO

The short-term effects of smoking one to three marihuana cigarettes (900 mg of marihuana per cigarette; 2.2% delta9-tetrahydrocannabinol) on left ventricular performance were evaluated in 21 experienced users of cannabis at different times during a 94-day in-hospital study of the biologic effect of daily heavy smoking of marihuana. In six subjects, cardiac output was determined using the indocyanine-green dye-dilution technique; and in two of these individuals and 15 additional subjects, cardiac output, ejection fraction, preejection period (PEP), left ventricular ejection time (LVET), and the velocity of circumferential fiber shortening (Vcf) were determined using echocardiograms, phonocardiograms, and carotid pulse recordings. Following the smoking of one to three marihuana cigarettes, the heart rate rose 16 to 53 percent, cardiac output rose 4 to 9 percent, stroke volume did not change or fell slightly, and ejection fraction, PEP/LVET, and did not change, except for a slight increase in Vcf (15%) after three marihuana cigarettes, which could be accounted for by the associated increase in heart rate (53%). These findings suggest that in long-term heavy users of cannabis, marihuana has no significant effect on myocardial contractility independent of its effect on heart rate.


Assuntos
Canabinoides/farmacologia , Cannabis , Frequência Cardíaca/efeitos dos fármacos , Contração Miocárdica/efeitos dos fármacos , Adulto , Débito Cardíaco/efeitos dos fármacos , Ensaios Clínicos como Assunto , Técnica de Diluição de Corante , Ecocardiografia , Eletrocardiografia , Humanos , Masculino , Fonocardiografia , Estimulação Química
15.
Am Heart J ; 91(1): 18-20, 1976 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1244718

RESUMO

The echocardiograms of seven patients with large pericardial effusions were found to show posterior motion of the mitral leaflets in systole as seen in prolapse of the mitral valve. Repeat echocardiograms after resolution of the effusion revealed normal mitral valve motion. None of the patients had clinical evidence of prolapsed mitral valve. We postulate that a posterior swing of the heart within the pericardial fluid occurring in late systole causes posterior displacement of the mitral valve simulating a prolapsed valve.


Assuntos
Ecocardiografia , Insuficiência da Valva Mitral/diagnóstico , Valva Mitral/fisiopatologia , Derrame Pericárdico/diagnóstico , Diagnóstico Diferencial , Ruídos Cardíacos , Humanos , Insuficiência da Valva Mitral/etiologia , Contração Miocárdica , Derrame Pericárdico/complicações , Derrame Pericárdico/fisiopatologia
16.
Circulation ; 51(3): 511-4, 1975 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-1139760

RESUMO

A reduced rate of diastolic closure of the anterior mitral leaflet has been shown to occur in mitral stenosis, primary pulmonary hypertension, and in cases with reduced left ventricular compliance. Posterior notion of the posterior mitral leaflet in diastole has been the distinguishing feature to rule out the diagnosis of mitral stenosis. We have analyzed echocardiograms of 167 patients with mitral stenosis and have found 16 cases where the posterior mitral leaflet moved posteriorly, that is, in an opposite direction from the anterior mitral leaflet. Two other features were found that were helpful in establishing the diagnosis of mitral stenosis in these atypical cases, namely, thickening of the mitral leaflets and reduction or absence of the artrial wave.


Assuntos
Estenose da Valva Mitral/fisiopatologia , Valva Mitral/fisiopatologia , Adolescente , Adulto , Ecocardiografia , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Hipertensão Pulmonar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estenose da Valva Mitral/diagnóstico
17.
Circulation ; 61(1): 143-7, 1980 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-7349928

RESUMO

Sensitivity and specificity of detection of mitral regurgitation was assessed by range-gated Doppler echocardiography. The degree of mitral regurgitation was also estimated by the depth and width of the regurgitant jet detected with Doppler and compared with that assessed by left ventriculography. Of 47 patients with an adequate Doppler study, 24 had no mitral regurgitation by ventriculography. All but one were also negative for mitral regurgitation by Doppler, for a specificity of 96%. Of 23 cases with mitral regurgitation documented by ventriculography, Doppler detected mitral regurgitation in 21, for a sensitivity of 92%. Two cases with mitral regurgitation undiagnosed by Doppler had mild mitral regurgitation due to papillary muscle dysfunction. All cases with rheumatic mitral regurgitation were detected. The degree of mitral regurgitation estimated with Doppler had a high correlation with that determined by ventriculography (r = 0.88, p less than 0.01).


Assuntos
Efeito Doppler , Ecocardiografia , Insuficiência da Valva Mitral/diagnóstico , Física , Adulto , Idoso , Débito Cardíaco , Diástole , Ventrículos do Coração/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Fonocardiografia , Fenômenos Físicos , Radiografia , Cardiopatia Reumática/diagnóstico , Sístole
18.
Cathet Cardiovasc Diagn ; 14(4): 243-7, 1988.
Artigo em Inglês | MEDLINE | ID: mdl-3396066

RESUMO

Prosthetic mitral valve regurgitation was evaluated by both pulsed Doppler ultrasound and left ventriculography. Pulsed Doppler ultrasound was found to have only a 20% sensitivity in detecting prosthetic mitral valve regurgitation documented by left ventriculography. Possible reasons for this poor sensitivity include 1) an eccentric jet not identified by the small pulsed Doppler sample volume; 2) prosthesis interference with the Doppler signal in the apical four chamber view; and 3) the large angle of incidence between the pulsed Doppler signal and the regurgitant jet. Mitral insufficiency, especially when not severe, may be missed by this technique. Care must be taken in interpreting negative results from a pulsed Doppler ultrasound evaluation of a prosthetic mitral valve.


Assuntos
Ecocardiografia , Próteses Valvulares Cardíacas/efeitos adversos , Insuficiência da Valva Mitral/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral , Estudos Retrospectivos
20.
Circulation ; 50(2): 412, 1974 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-4846650
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