ABSTRACT
Cardiovascular disease is the most frequent cause of death in patients with acromegaly. Recently, long-term treatment with a somatostatin analogue (Sandostatin LAR) has been shown to be effective in controlling growth hormone (GH) and insulin like growth factor-1 (IGF-1) hypersecretion in most patients with acromegaly. Along with the effectiveness in the hormone profile, Sandostatin LAR has been reported to be effective for tumor mass shrinkage and clinical symptom improvement. We have encountered a female acromeglic patient with severe dilated cardiomyopathy and the patient was treated with Sandostatin LAR After treatment for 12 months, as seen by follow up echocardiography, the overall cardiac function was significantly improved. We report the case with a review of the literature.
Subject(s)
Female , Humans , Acromegaly , Cardiomyopathy, Dilated , Cardiovascular Diseases , Cause of Death , Echocardiography , Follow-Up Studies , Growth Hormone , Insulin , Octreotide , SomatostatinABSTRACT
An acute myocardial infarction caused by a septic coronary embolism is a known complication of infective endocarditis and usually carries a fatal prognosis. We experienced a case of a 27-year-old man with an acute myocardial infarction caused by a coronary embolism due to bacterial endocarditis. An echocardiogram demonstrated mitral valve regurgitation with highly mobile multiple vegetations. Because of the high risk of systemic embolization and congestive heart failure, the patient underwent emergency surgery. Mitral valve replacement and an embolectomy were performed successfully without any surgical complications.
Subject(s)
Adult , Humans , Embolectomy , Embolism , Emergencies , Endocarditis , Endocarditis, Bacterial , Heart Failure , Mitral Valve , Mitral Valve Insufficiency , Myocardial Infarction , PrognosisABSTRACT
BACKGROUND: Early diagnosis and proper therapy of malfunctioning prosthetic heart valves remain a challange. Transthoracic echocardiography(TTE) is the diagnostic procedure of choice for the evaluation of malfunctioning prosthetic heart valves. Howerver, TTE may be limited owing to poor acoustic windows. Some of these limitations can be overcome by transesophageal echocardiography(TTE). METHODS: The study comprised 33 consecutive patients(20 male and 13 famale patients, age range 20 to 59) in congestive heart failure after remote mitral valve replacement with bioprosthesis. The patients were examined between 1987 and 1994. All the 33 patients were studied by TTE and 19 patients among these patients furthermore by TEE. The morphology of the explanted bioprosthesis was confirmed by surgery in all cases. RESULTS: The abnormalities of the bioprosthesis were diagnosed correctly by TTE in 32 cases. The more detailed morphology of the valves could be observed by TEE(19 cases). Only in one case a small thrombus in left atrium was overlooked in TTE examination, on the otherhand it was detectedd by TEE. The severity grade of mitral regurgitation was estimatedca. I' severer by TEE in 8 cases. In all TEE examination spontaneous echocontrast was observed in left atrium. The bioprostheses from CE(Carpentier-Edwards) showed higher tendency to cuspal tearing and perforation. CONCLUSION: TTE is the diagnostic procedure of choice on patients with bioprosthetic mitral valve replacement. TTE examination confirms immediately clinical diagnosis of bioprosthetic failure. The transesophageal approach promises more detailed informations about lesions of the degenerated bioprosthetic valves and left atrium.
Subject(s)
Humans , Male , Acoustics , Bioprosthesis , Diagnosis , Early Diagnosis , Echocardiography, Transesophageal , Estrogens, Conjugated (USP) , Heart Atria , Heart Failure , Heart Valves , Mitral Valve Insufficiency , Mitral Valve , ThrombosisABSTRACT
Blunt thorax trauma may produce a variety of cardiac lesions, which may occur alone or in combination. Nonpenetrating perforation of interventricular septum with chordae rupture of tricuspid valve is a infrequent pathologic event. A 40-years-old worker was transfered to hospital with increasing symptoms of right heart failure following a blunt compressing chest trauma with a huge overolling cement pipe(Wt.680kg) 6 weeks ago. The immediately diagnosed serial rib fracture of the left thorax cage and dislocation of the left acromoclavicular joint were treat conservatively. A conventional transthoracic color Doppler and two dimensional echocardiogram detected traumatic ventricular septal defect with bilatral shunt and tricuspid regurgitation. An additional transesophageal color echocardiopraphic demonstrated the ruptured chordae tendineae of the tricuspid septal leafet, which prolapsed deeply into the right atrium. The conventional color Doppler echocardiopraphy enhances the ability to detect the presence of a ventricular septal perforation and valve dysfunction in a patient with cardiac contusion. The transesophageal echocardiopraphy is a useful semiinvasive tool for the detailed morphological evaluation of atrioventricular valves and their substructure.
Subject(s)
Humans , Chordae Tendineae , Contusions , Joint Dislocations , Echocardiography , Heart Atria , Heart Failure , Heart Septal Defects, Ventricular , Joints , Rib Fractures , Rupture , Thorax , Tricuspid Valve , Tricuspid Valve Insufficiency , Ventricular Septal RuptureABSTRACT
In mitral valve disease, mural thrombus in the left atrium is common, particulary in the atrial appendage in patients with atrial fibrillation. Occasionally, the angiographic sign of "neovascularity" and "fistula" in the region of the left atrial appendage during coronary arteriography has been reported to indicate the presence of thrombus in the left atrium, which might not even be revealed by transthoracic two-dimensional echocardiography. We observed coronary neovascularity and fistula formation in two pateints with mitral stenosis and these findings were due to organized mural thrombus that was adherent to the wall of the left atrial appendage. So we report 2 cases with brief review of literature.
Subject(s)
Humans , Angiography , Atrial Appendage , Atrial Fibrillation , Echocardiography , Fistula , Heart Atria , Mitral Valve , Mitral Valve Stenosis , ThrombosisABSTRACT
The authors reported here a 23 years-old female patient with acute renal failure and anaphylaxis induced by rifampicin, who was suffered from exudative pericarditis. The diagnosis was made by its reproducibility with rifampicin. The pathogenesis of acute renal failure and anaphylaxis in this case was thought to be immunologic mechanism, because of elevated IgE and depressed complements. Relevant literature was also reviewed.