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1.
Arch. argent. pediatr ; 119(4): e349-e352, agosto 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1281786

ABSTRACT

El rabdomiosarcoma es el tumor maligno de partes blandas más frecuente en la edad pediátrica. Puede afectar cualquier localización anatómica. El subtipo histológico alveolar suele causar lesiones en las extremidades en niños de mayor edad. Los sitios metástasicos más frecuentes son el pulmón, la médula ósea, el hueso y los ganglios linfáticos. Describimos el caso de un paciente con rabdomiosarcoma alveolar (RA) con metástasis cardíaca, una presentación poco frecuente de la patología.


Rhabdomyosarcoma is the most common malignant soft tissue tumor in pediatric age. It can affect any anatomical location. Alveolar histological subtype usually presents lesions on the extremities in older children. The most common metastatic sites are the lung, bone marrow, bone and lymph node. We describe a case of alveolar rhabdomyosarcoma with cardiac metastasis in a pediatric patient, a rare presentation of the pathology.


Subject(s)
Humans , Male , Child , Soft Tissue Neoplasms/pathology , Rhabdomyosarcoma, Alveolar/pathology , Foot Diseases/pathology , Heart Neoplasms/secondary , Rhabdomyosarcoma, Alveolar/diagnosis , Rhabdomyosarcoma, Alveolar/therapy , Ventricular Septum , Foot Diseases/diagnosis , Foot Diseases/drug therapy , Heart Neoplasms/diagnosis , Heart Neoplasms/drug therapy , Neoplasm Staging
3.
Article in English | WPRIM | ID: wpr-880670

ABSTRACT

OBJECTIVES@#To compare the left ventricular systolic function between the 1eft bundle branch pacing (LBBP) and right ventricular septum pacing (RVSP) in patients with pacemaker dependence by three-dimensional speckle tracking imaging (3D-STI).@*METHODS@#A total of 65 patients with atrioventricular block (AVB) (Mobitz type II second-degree AVB, high-degree AVB, or third-degree AVB), who underwent permanent cardiac pacing implantation including 32 patients receiving LBBP (LBBP group) and 33 patients receiving RVSP (RVSP group) from June 2018 to June 2019,were enrolled in this study. These patients met the following inclusion criterion: pre-operative left ventricular ejection fraction (LVEF)>50% and ventricular pacing rate>40% at 6-month programming follow-up; and the patients underwent echocardiography at pre-operation and 6 months after operation. The 3D-STI was used to obtain global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS).@*RESULTS@#All the patients in the LBBP group and the RVSP group had normal LVEF, there was no significant difference between the 2 group (@*CONCLUSIONS@#For patients with pacemaker dependence and normal LVEF at pre-operation, the cardiac function in the LBBP group is not significantly better than that in the RVSP group in short term follow-up. But in terms of physiologic pacing and long-term cardiac function protection, the 1eft bundle branch pacing is an optimal pacing mode.


Subject(s)
Bundle of His , Cardiac Pacing, Artificial , Humans , Pacemaker, Artificial , Stroke Volume , Ventricular Function, Left , Ventricular Septum/diagnostic imaging
4.
Article in Portuguese | LILACS | ID: biblio-1254149

ABSTRACT

Tumores cardíacos primários consistem em patologia rara, sendo encontrados em até 0,03% das autópsias e a maioria benigna. Dentre os benignos, os lipomas apresentam incidência de 8,5%, localizando-se mais frequentemente no septo interatrial. Quando localizado no septo interventricular, é considerado patologia ainda mais incomum, com prevalência real desconhecida. Na maioria dos casos, o diagnóstico ocorre de forma incidental, por exame de imagem cardiovascular, e pode ser confirmado por exame histopatológico. Apresentam-se mais comumente de forma assintomática ou com sintomas inespecíficos, mas podem evoluir com arritmias, disfunção valvar, insuficiência cardíaca e óbito, o que ressalta a importância dos métodos de imagem cardiovascular no diagnóstico diferencial e na orientação da terapêutica adequada. O presente trabalho relata o caso de um paciente com achado ecocardiográfico incidental de massa cardíaca localizada no septo interventricular, seguindo da realização de ressonância magnética cardíaca, para melhor caracterização da lesão e demonstração de características compatíveis com lipoma.(AU)


Subject(s)
Humans , Female , Aged , Pulmonary Disease, Chronic Obstructive/complications , Ventricular Septum/pathology , Heart Ventricles/pathology , Lipoma/etiology , Lipoma/diagnostic imaging , X-Rays , Biopsy/methods , Echocardiography/methods , Magnetic Resonance Spectroscopy/methods , Comorbidity , Electrocardiography
6.
Rev. bras. cir. cardiovasc ; 35(1): 113-116, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1092459

ABSTRACT

Abstract A 30-month-old male patient with transposition of the great arteries with intact ventricular septum (TGA/IVS) is presented. Arterial switch operation (ASO) was performed in the light of echocardiographic and angiographic findings. The patient remained under extracorporeal membrane oxygenation support for seven days postoperatively, and his cardiac functions returned to normal at the postoperative 10th day. He was discharged at the postoperative 20th day. The present case, which presents one of the most advanced ages at operation for TGA/IVS among previously reported cases, is used to discuss late ASO in this study.


Subject(s)
Male , Child, Preschool , Transposition of Great Vessels , Extracorporeal Membrane Oxygenation , Ventricular Septum/surgery , Arterial Switch Operation , Treatment Outcome
7.
Rev. bras. cir. cardiovasc ; 35(2): 235-238, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101487

ABSTRACT

Abstract The cardiac involvement of hydatid cyst, which is rarely seen, with the location of asymptomatic huge cyst in the interventricular septum (IVS) is an extraordinary condition. We report an isolated cardiac hydatid cyst located in the IVS in an 18-year-old man diagnosed incidentally by transthoracic echocardiography. Cardiac magnetic resonance imaging confirmed a mass lesion of 47×74 mm in diameter located at the base of IVS. The cystic content and its germinative membrane were resected and the cavity was applicated under cardiopulmonary bypass. Postoperative course was uneventful and the patient was discharged on the 6th postoperative day, with oral albendazole therapy.


Subject(s)
Humans , Male , Adolescent , Echinococcosis , Ventricular Septum , Magnetic Resonance Imaging , Echocardiography , Albendazole
8.
Rev. colomb. cardiol ; 25(6): 405-405, nov.-dic. 2018. graf
Article in English | LILACS, COLNAL | ID: biblio-1058368

ABSTRACT

Abstract In the era of primary percutaneous coronary intervention, mechanical complications after acute myocardial infarction are extremely rare, with an incidence of less than 0.5%. Rupture of the ventricular septum is the least frequent occurrence. Despite early surgical repair, mortality still remains high. Patients who are at high risk of perioperative death include those with cardiogenic shock and multiorgan dysfunction. In this group, a mechanical circulatory support such as an Extracorporeal Membrane Oxygenation circuit could be used as bridge to surgical repair is feasible or heart transplantation, as it provides hemodynamic stability and the potential to correct multiorgan dysfunction. We reported a case pf ECMO device implantation as a bridge to heart transplantation in a patient with post infarction ventricular septal rupture. Unfortunately, while on the waiting list for heart transplantation with maximum priority the patient had massive diffuse alveolar hemorrhage secondary to the anticoagulation required by the equipment and died.


Resumen En la era de la intervención coronaria percutánea primaria, las complicaciones mecánicas tras un infarto de miocardio agudo son extremadamente infrecuentes, con una incidencia de menos del 0,5%. La ruptura del septum ventricular es el caso menos frecuente. A pesar de la reparación quirúrgica, la mortalidad sigue siendo elevada. Los pacientes con alto riesgo de muerte perioperativa incluyen a aquellos con shock cardiógeno y síndrome de disfunción multiorgánica. En este grupo, podría utilizarse soporte circulatorio mecánico, tal como el circuito de oxigenación por membrana extracorpórea, como puente hacia la reparación quirúrgica o trasplante cardiaco, ya que aporta estabilidad dinámica y la posibilidad de corregir el síndrome de disfunción multiorgánica. Se reporta un caso de implantación de dispositivo de membrana extracorpórea, como puente al trasplante cardiaco, en un paciente con ruptura del septum ventricular tras infarto. Lamentablemente, a pesar de estar en lista de espera con prioridad máxima, sufrió una hemorragia alveolar difusa masiva, secundaria a la anticoagulación requerida por el equipo, y falleció.


Subject(s)
Humans , Male , Aged , Extracorporeal Membrane Oxygenation , Ventricular Septum , Cardiology , Myocardial Infarction
9.
Arq. bras. cardiol ; 111(5): 656-663, Nov. 2018. tab
Article in English | LILACS | ID: biblio-973786

ABSTRACT

Abstract Background: Majority of the incidentally discovered adrenal masses, called adrenal incidentaloma (AI), are nonfunctioning adrenal adenomas. The appropriate management of AI is still a matter debate, so it is necessary to investigate their associated morbidity. However, data regarding morphological and functional cardiac alterations are limited in this group. Objective: In this study, we aimed to assess cardiac structural and functional characteristics and atrial conduction properties in patients with nonfunctioning AI. Methods: Thirty patients with nonfunctioning AI and 46 properly matched control subjects were included in the study. After hormonal and biochemical analysis, all participants underwent transthoracic echocardiography to obtain systolic and diastolic parameters of both ventricles, in addition to atrial conduction times by tissue Doppler echocardiography. Data were analyzed with Statistical Package for the Social Sciences (SPSS, Chicago, IL, United States) statistics, version 17.0 for Windows. P < 0.05 was considered statistically significant. Results: Left ventricular (LV) mass index and LV myocardial performance index were significantly increased in AI group. Among atrial conduction times, both intra- and interatrial electromechanical delays were significantly prolonged in patients with nonfunctioning AI. Other laboratory and echocardiographic findings were similar between groups. Conclusion: Our study revealed that intra- and inter-atrial conduction times were prolonged, and LV mass index was increased in patients with nonfunctioning AI. These findings may be markers of subclinical cardiac involvement and tendency to cardiovascular complications. Close follow-up is necessary for individuals with nonfunctioning AI for their increased cardiovascular risk.


Resumo Fundamento: A maioria das massas adrenais descobertas incidentalmente, denominadas incidentaloma adrenal (IA), são adenomas adrenais não funcionantes. O manejo adequado da IA ainda é um tema de debate, e por isso é necessário investigar suas morbidades associadas. Entretanto, dados referentes a alterações cardíacas morfológicas e funcionais são limitados nesse grupo. Objetivo: Neste estudo, objetivamos avaliar as características estruturais e funcionais cardíacas e as propriedades de condução atrial em pacientes com IA não funcionante. Métodos: Trinta pacientes com IA não funcionante e 46 controles adequadamente pareados foram incluídos no estudo. Após análise hormonal e bioquímica, todos os participantes foram submetidos a ecocardiograma transtorácico para obtenção de parâmetros sistólicos e diastólicos de ambos os ventrículos, além dos tempos de condução atrial pelo ecocardiograma com Doppler tecidual. Os dados foram analisados com o Statistical Package for the Social Sciences (SPSS, Chicago, IL, Estados Unidos), versão 17.0 para Windows. P < 0,05 foi considerado estatisticamente significativo. Resultados: O índice de massa do ventrículo esquerdo (VE) e o índice de desempenho miocárdico do VE foram significativamente aumentados no grupo IA. Entre os tempos de condução atrial, os atrasos eletromecânicos intra- e interatriais foram significativamente prolongados em pacientes com IA não funcionante. Outros achados laboratoriais e ecocardiográficos foram semelhantes entre os grupos. Conclusão: Nosso estudo revelou que os tempos de condução intra- e interatrial estavam prolongados e o índice de massa do VE estava aumentado em pacientes com IA não funcionante. Esses achados podem ser marcadores de envolvimento cardíaco subclínico e de tendência a complicações cardiovasculares. Um acompanhamento rigoroso é necessário para indivíduos com IA não funcionante, devido ao aumento do risco cardiovascular.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Echocardiography, Doppler/methods , Adenoma/complications , Adrenal Gland Neoplasms/complications , Cardiac Conduction System Disease/complications , Hydrocortisone/blood , Echocardiography/methods , Cross-Sectional Studies , Atrial Function , Hypertrophy, Left Ventricular/diagnostic imaging , Adrenocorticotropic Hormone/blood , Incidental Findings , Ventricular Septum/physiopathology , Ventricular Septum/diagnostic imaging , Cardiac Conduction System Disease/physiopathology , Cardiac Conduction System Disease/diagnostic imaging
10.
Arch. cardiol. Méx ; 88(3): 212-218, jul.-sep. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-1088752

ABSTRACT

Resumen Objetivos: Las vías accesorias (VAc) fascículo-ventriculares (FV) tienen una localización anatómica similar a las VAcanteroseptales derechas (ASD) y comparten características electrocardiográficas. El objetivo es comparar características electrocardiográficas de las VAC FV con las de las ASD en pediatría. Métodos: Se incluyeron pacientes con preexcitación manifiesta sometidos a estudio electrofisiológico. Las VAc FV se definieron por un intervalo HV ≤ 32ms y un alargamiento del AH sin modificación del HV, del grado o patrón de preexcitación ventricular durante la estimulación auricular. Tres observadores independientes y ciegos analizaron los ECG en cada grupo. Resultados: De 288 pacientes, 15 (5.2%) presentaban VAC FV y 14 VAC ASD (4.9%). El intervalo PR fue más largo en las VAc FV que en las ASD (113 ± 21 vs. 86 ± 13 ms respectivamente; p = < 0.001) y la duración del QRS fue menor (95 ± 12 vs. 137 ± 24 ms respectivamente; p = < 0.001). El ECG de las VAc FV presentó una deflexión rápida de baja amplitud previa al inicio del QRS en 13 de 15 pacientes (87%) y en 2 con VAc AV ASD (14%); (p = 0.003). Conclusiones: El intervalo PR fue más largo y el complejo QRS más angosto en la VAC FV respecto de las ASD. La presencia de una deflexión rápida de baja amplitud previa al inicio del QRS permitiría diferenciarlas de las aurículo-ventriculares ASD de manera no invasiva.


Abstract Objectives: Fasciculo-ventricular (FV) accessory pathways (AP's) and right anteroseptal (RAS) AP's share similar anatomic locations and electrocardiographic characteristics. The objective of this article is to compare these features in children. Methods: All patients with manifest pre-excitation who underwent an electrophysiological study were included. Fasciculo-ventricular AP's were defined by the presence of an HV inter- val ≤ 32 ms and a prolongation of the AH without changes in the HV interval, or the level of pre-excitation during atrial pacing. Three independent and blind observers analysed the ECG's in both groups. Results: Out of 288 patients, 15 (5.2%) had FV AP's and 14 (4.9%) right AS AP's. The PR interval was longer in FV AP's than in RAS (113 ± 21 vs 86 ± 13 ms respectively; P < .001) and the QRS was narrower (95 ± 12 vs 137 ± 24 ms respectively; P < .001). The ECG in patients with FV AP's showed a rapid low amplitude deflection at the begining of the QRS in 13 out of 15 patients (87%) and in 2 (14%) the RAS AP group (P = .003). Conclusions: The PR interval was longer and the QRS complex was narrower in patients with FV AP's. The presence of a rapid low amplitude deflection at the beginning of the QRS complex would allow to differentiate them from RAS AP's non-invasively.


Subject(s)
Humans , Male , Female , Child , Adolescent , Wolff-Parkinson-White Syndrome/diagnosis , Electrocardiography/methods , Ventricular Septum/physiopathology , Accessory Atrioventricular Bundle/diagnosis , Wolff-Parkinson-White Syndrome/physiopathology , Retrospective Studies , Electrophysiologic Techniques, Cardiac , Accessory Atrioventricular Bundle/physiopathology
11.
ABC., imagem cardiovasc ; 31(3)jul.-set. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-909414

ABSTRACT

Fundamento: A hipertensão pulmonar é potencialmente fatal, com grande impacto na qualidade de vida do paciente. O tratamento pode alterar sua progressão, mas o aumento na sobrevida é relacionado ao diagnóstico e à terapêutica precoces. Objetivo: Analisar a relação entre alterações em exames usados de rotina (ecocardiografia, eletrocardiografia e tomografia computadorizada) e o aumento da pressão sistólica da artéria pulmonar. Métodos: Avaliamos fichas de pacientes portadores de hipertensão pulmonar, separando-os em dois grupos de acordo com a pressão sistólica da artéria pulmonar estimada à ecocardiografia. O Grupo 1 consistiu de pacientes com pressão sistólica da artéria pulmonar entre 35 e 65 mmHg, e o Grupo 2, de pacientes com pressão sistólica da artéria pulmonar > 65 mHg. Analisamos a prevalência de alterações sugestivas de hipertensão pulmonar em exames de ecocardiografia, eletrocardiografia e tomografia computadorizada. Foram realizadas análises descritiva dos dados e comparativa entre os grupos.Resultados: Foram analisados 101 pacientes (43 do Grupo 1 e 58 do Grupo 2). A maioria foram mulheres (82). Valores maiores de pressão sistólica da artéria pulmonar foram correlacionados com dilatação de câmaras direitas à ecocardiografia (p < 0,001). À eletrocardiografia, sinais de hipertrofia direita e presença de padrão strain ventricular foram mais prevalentes no Grupo 2 (p < 0,05). À tomografia computadorizada, observaram-se maiores diâmetros de tronco da artéria pulmonar em pacientes do Grupo 2 (p < 0,05). Houve correlação entre progressão clínica da doença pelo escore e aumento da pressão sistólica da artéria pulmonar (p < 0,05).Conclusão: É possível, em um primeiro momento, fazer uso do exame clínico e da eletrocardiografia para uma estimativa da gravidade do quadro de hipertensão pulmonar. Os achados, então, devem ser confirmados com análise secundária por tomografia computadorizada e ecocardiografia


Introduction: Pulmonary hypertension is potentially fatal and courses with important day-to-day limitation. While the treatment is capable of slowing the disease's progression, increase in life expectancy is directly linked to early diagnosis and treatment. Objectives:To analyze the relation between alterations detectable on routine exams performed on pulmonary hypertension patients (echocardiography, electrocardiography and computerized tomography) and increases on pulmonary artery systolic pressure. Methods: We analyzed the recordings of patients presented with pulmonary hypertension, and separated them in two groups based on their echocardiography-estimated pulmonary artery systolic pressure. Group 1 was composed of patients with pulmonary artery systolic pressure between 35 mmHg and 65 mmHg, and Group 2 of patients with pulmonary artery systolic pressure > 65 mmHg. We analyzed the prevalence of alterations suggestive of pulmonary hypertension on echocardiography, electrocardiography and computerized tomography. A descriptive analysis of the findings was conducted, followed by comparative analysis between the groups. Results: We analyzed 101 patients (43 from Group 1 and 58 from Group 2). Most were women (82). Higher pulmonary artery systolic pressure values were correlated with right-heart dilation on echocardiography (p < 0.001). Electrocardiography findings revealed that right-heart hypertrophy and ventricular strain pattern were more common on Group 2 (p < 0.05). Computerized tomography analysis showed Group 2 patients had superior pulmonary artery diameters (p < 0.05). There was correlation between high pulmonary artery systolic pressure and clinical progression of the disease measured via the NYHA score (p < 0.05). Conclusion: It is possible to make use of clinical examination and a simple electrocardiography to stratify the severity of a pulmonary artery patient. Computerized tomography and echocardiography should be used to confirm these findings


Subject(s)
Humans , Male , Female , Middle Aged , Echocardiography/methods , Electrocardiography/methods , Hypertension, Pulmonary/diagnosis , Medical Examination/methods , Blood Pressure , Diagnostic Imaging/methods , Heart Ventricles , Prevalence , Pulmonary Artery , Retrospective Studies , Sex Factors , Data Interpretation, Statistical , Stroke Volume , Tomography, X-Ray Computed/methods , Ventricular Septum
13.
RELAMPA, Rev. Lat.-Am. Marcapasso Arritm ; 31(1): 8-12, jan.-mar. 2018. ilus
Article in Portuguese | LILACS | ID: biblio-905668

ABSTRACT

diagnóstico concomitante de bloqueio de ramo esquerdo e bloqueio divisional ântero-superior esquerdo é motivo de controvérsias entre cardiologistas, principalmente quando há desvio do eixo vetorcardiográfico do coração para a esquerda. Em uma breve revisão da literatura, descrevemos a anatomia do feixe de His e sua natureza trifascicular, apresentamos a teoria tetrafascicular de Medrano e relembramos os critérios diagnósticos dessas duas entidades eletrocardiográficas. Concluímos que o bloqueio concomitante pode ser encontrado em casos de bloqueios pós-divisionais bifasciculares com maior acometimento do bloqueio divisional ântero-superior. Por outro lado, o cardiologista precisa ter em mente que existem outras causas de desvio do eixo para a esquerda em vigência de bloqueio de ramo esquerdo, entre elas: bloqueio de ramo esquerdo com infarto inferior, bloqueio de ramo esquerdo com infarto agudo do miocárdio ântero-septal e lateral, e vias acessórias atípicas


The concomitant diagnosis of left bundle branch block and anterosuperior hemi-block is controversial among cardiologists, especially when there is left vectorcardiographic axis deviation. In a brief literature review, we describe His bundle's anatomy and its trifascicular nature, we present Medrano's quadrifascicular theory and revise the diagnostic criteria of these two electrocardiographic entities. We conclude that concomitant block might be found in cases of post-divisional bifascicular blocks with greater involvement of the anterosuperior hemiblock. On the other hand, the cardiologist must keep in mind that there are other causes of left axis deviation in the presence of left bundle branch block, such as: inferior infarction, anterior-septal and lateral infarction, and atypical bypass tracts


Subject(s)
Humans , Bundle-Branch Block , Electrocardiography/methods , Vectorcardiography/methods , Atrioventricular Node , Bundle of His/anatomy & histology , Heart , Heart Ventricles , Ventricular Septum
14.
Chinese Journal of Lung Cancer ; (12): 397-402, 2018.
Article in Chinese | WPRIM | ID: wpr-772428

ABSTRACT

BACKGROUND@#To study the characteristics of ventricular function in Pulmonary Hypertension (PH) Patients with different shape of Interventricular Septum (IVS) by cardiac magnetic resonance (CMR).@*METHODS@#36 PH patients diagnosed by right heart catheterization accepted CMR. According to the morphology of IVS, the patients were divided into two groups: the non-deformation group (10 patients) and the deformation group (26 patients). The ventricular function parameters were as follows: RV and LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI), cardiac index (CI), ejection fraction (EF), and myocardial mass index (MMI).@*RESULTS@#ANOVA analysis showed that the differences of RVEDVI, RVESVI, RVSVI, RVCI, RVEF, RVMMI, LVEDVI, LVESVI, LVSVI and LVCI were significant among the three groups. Compared with control group, RVSVI (P=0.017), RVEF (P<0.001), LVEDVI (P=0.048) and LVSVI (P=0.015) decreased in IVS non-deformation group. Compared with IVS non-deformation group, RVEDVI (P<0.001), RVESVI (P<0.001), RVCI (P=0.002) and RVMMI (P=0.017) were increased in IVS deformation group; while RVEF (P=0.001), LVEDVI (P=0.003), LVSVI (P<0.001) and LVCI (P=0.029) were decreased. Compared with the control group, RVEDVI (P<0.001), RVESVI (P<0.001), RVCI (P=0.004) and RVMMI (P=0.003) were increased in the IVS deformation group, while RVEF (P<0.001), LVEDVI (P<0.001), LVESVI (P<0.001), LVSVI (P<0.001), LVCI (P<0.001) were decreased.@*CONCLUSIONS@#Ventricular function is different in PH Patients with different IVS shape. The IVS shape can represent the changes of ventricular function in PH patients.


Subject(s)
Adult , Aged , Female , Heart , Diagnostic Imaging , Humans , Hypertension, Pulmonary , Diagnosis , Diagnostic Imaging , Lung Neoplasms , Magnetic Resonance Imaging , Male , Middle Aged , Stroke Volume , Ventricular Function , Ventricular Septum , Diagnostic Imaging
15.
Article in English | WPRIM | ID: wpr-63841

ABSTRACT

We report a rare case of subependymal giant cell astrocytoma (SEGA) associated with tumoral bleeding in a pediatric patient without tuberous sclerosis complex (TSC). A 10-year-old girl presented with a 2-week history of an increasingly aggravating headache. Brain magnetic resonance imaging revealed an approximately 3.6-cm, well-defined, heterogeneously enhancing mass with multistage hemorrhages on the right-sided foramen of Monro. The tumor was completely resected using a transcallosal approach. Intraoperatively, the mass presented as a gray-colored firm tumor associated with acute and subacute hemorrhages. The origin of the mass was identified as the ventricular septum adjacent to the foramen of Monro. A pathological analysis revealed pleomorphic multinucleated eosinophilic tumor cells with abundant cytoplasm. These cells showed positive staining for the glial fibrillary acidic protein and S100 protein. A diagnosis of SEGA was established. The patient recovered without any neurological symptoms. There was no evidence of TSC. The radiological follow-up showed no recurrence for 2 years. This was a case of SEGA with intratumoral hemorrhage, for which a favorable outcome was achieved, without any neurological deficit after tumoral resection.


Subject(s)
Astrocytoma , Brain , Cerebral Ventricles , Child , Cytoplasm , Diagnosis , Eosinophils , Female , Follow-Up Studies , Glial Fibrillary Acidic Protein , Headache , Hemorrhage , Humans , Magnetic Resonance Imaging , Recurrence , Tuberous Sclerosis , Ventricular Septum
16.
Medicina (B.Aires) ; 76(5): 321-325, Oct. 2016. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-841602

ABSTRACT

La estimulación por marcapasos se asocia con eventos adversos graves. En la siguiente serie de casos se evaluó la disincronía mecánica intraventricular izquierda (DMVI) en la estimulación endocárdica prolongada del ventrículo derecho a nivel septal. Se estudiaron 6 personas con marcapasos implantados no antes de un año utilizando SPECT gatillado con 99mTc-MIBI y análisis de fase en reposo. Se registraron variables clínicas, duración del QRS, tasa y modo de estimulación ventricular, presencia y extensión de isquemia y/o infarto, volúmenes cavitarios y FEVI en reposo. Utilizando V-Sync de Emory Cardiac Toolbox se obtuvieron el ancho de banda (AB) y el desvío estándar de fase (DEF) en reposo (grados), comparándolos con una población control. La estimulación endocárdica prolongada en el septum ventricular derecho se asoció con marcada DMVI, aun cuando la función sistólica estaba conservada. Aquellos con FEVI moderada/gravemente disminuida (caracterizados por diámetros cavitarios mayores, infarto o isquemia grave) exhibieron mayor disincronía que aquellos con FEVI conservada/levemente disminuida (AB: 177.3o vs. 88.3o; DEF: 53.1o vs. 33.8o). En los casos con cardiopatía isquémica portadores de marcapasos, el AF es una herramienta válida de potencial utilidad para evaluar la disincronía asociada al infarto y, eventualmente, aportar a la decisión oportuna del pasaje al modo de estimulación biventricular.


Pacemaker stimulation is associated with unpredictable severe cardiac events. We evaluated left ventricular mechanical dyssynchrony (LVMD) during prolonged septal right ventricular pacing. We performed 99mTc-MIBI gated-SPECT and phase analysis in 6 patients with pacemakers implanted at least one year before scintigraphy due to advanced atrioventricular block. Using V-Sync of Emory Cardiac Toolbox we obtained phase bandwidth (PBW) and standard deviation (PSD) from rest phase histogram. Clinical variables, QRS duration, rate and mode of pacing in septal right ventricle wall, chamber diameters, presence and extension of myocardial scar and ischemia and rest LVEF were recorded. Prolonged septal endocardial pacing is associated with marked LVMD, even when systolic function was preserved. More severe dyssynchrony was found in patients with impaired LVEF, higher left ventricle diameters, extensive infarct or severe ischemia than in patients with preserved LVEF (PBW: 177.3o vs. 88.3o; PSD: 53.1o vs. 33.8o). In the patients with ischemic heart disease and pacemaker, gated-SPECT phase analysis is a valid and potentially useful technique to evaluate LMVD associated with myocardial scar and to decide the upgrading to biventricular pacing mode.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Pacemaker, Artificial/adverse effects , Ventricular Dysfunction, Left/etiology , Ventricular Dysfunction, Left/physiopathology , Ventricular Septum/physiopathology , Severity of Illness Index , Ventricular Dysfunction, Left/diagnostic imaging , Electrocardiography , Ventricular Septum/diagnostic imaging , Atrioventricular Block/surgery , Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography , Myocardial Infarction/etiology , Myocardial Infarction/diagnostic imaging
17.
JPMA-Journal of Pakistan Medical Association. 2015; 65 (3): 296-299
in English | IMEMR | ID: emr-153821

ABSTRACT

To study the effects of ethanol vapour exposure on development of atrial and ventricular septa of chick embryo. The experimental study was conducted at the College of Physicians and Surgeons, Islamabad, from 2006 to 2007. The experimental and control groups were further divided into three subgroups based on the day of sacrifice. The experimental group was exposed to ethanol vapours produced in a specially-designed vapour chamber and then compared with age-matched controls. There were 90 eggs in each of the two groups. The development of inter-ventricular septum completed at day 7 of development in chick embryo. Ethanol vapour exposure produced a small discontinuity at day 10 of development in a chick embryo which may be labelled as ventricular septal defect since ventricular development is completed by day7. Interatrial septum formed till day 7 with small perforations which persisted till hatching. Ethanol vapour exposure may lead to ventricular septal defect


Subject(s)
Animals , Chick Embryo , Atrial Septum , Ventricular Septum , Heart Septal Defects, Ventricular
18.
Chinese Journal of Cardiology ; (12): 960-964, 2015.
Article in Chinese | WPRIM | ID: wpr-317632

ABSTRACT

<p><b>OBJECTIVE</b>To summarize the clinical characteristics and cardiac imaging features by focusing the diagnostic value of MRI in patients with cardiac amyloidosis (CA).</p><p><b>METHODS</b>A total of 31 cases with pathologically proven CA from January 2013 to December 2014 were included in this retrospective study.</p><p><b>RESULTS</b>Patients expressed typical disease manifestations at a late age (54±11) years. Majority patients were male (20 cases, 64.5%) in this cohort. Blood pressure was normal, 13 cases (42.9%) presented with edema in lower limbs, 12 cases (38.7%) with chest distress and dyspnea and 9 cases (29.0%) with abdominal pain and diarrhea. Electrocardiogram (ECG) features were as follows: 20 cases (64.5%) with low voltage in limb leads, 20 cases (64.5%) with poor R-wave progression in precordial leads, 17 cases (54.8%) with pseudo-necrotic Q wave and 27 cases (87.1%) with ST-T changes. Echocardiography examination showed that 25 (80.6%) of 31 cases were with left atrial enlargement, 22 cases (71%) with increased ventricular septal thickness and 12 cases (38.7%) with myocardial ground-glass opacity, 24 cases (77.4%) presented restrictive left ventricular filling pattern, 14 cases (45.2%) showed impaired left ventricular systolic function and 10 cases (32.3%) expressed abnormal left ventricular eject function (<50%). Cardiac MRI features were as follows: among 31 patients, 7 patients underwent cardiac MRI. Left ventricular and interventricular septum hypertrophy were vsulized in 6 cases, increased thickness of interatrial spetum in 3 cases, left atrial enlargement in 4 cases and right atrial enlargement in 3 cases. MRI also revealed a distinct diffuse delayed gadolinium enhancement of subendocardial and interventricular septum in 3 cases, 1 of which was with delayed enhancement of interatrial spetum.</p><p><b>CONCLUSIONS</b>Clinically, CA diagnosis should be considered for patients with manifestations of chest distress and edema in lower limbs, ECG features of low voltage in limb leads, poor R-wave progression and pseudo-necrotic Q wave, myocardial hypertrophy with myocardial ground-glass opacity in echocardiography and a characteristic MRI pattern of diffuse subendocardial delayed gadolinium enhancement even without the pathological proof.</p>


Subject(s)
Amyloidosis , Echocardiography , Electrocardiography , Female , Gadolinium , Heart Diseases , Heart Ventricles , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Myocardium , Retrospective Studies , Systole , Ventricular Septum
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