Assessment of Left Ventricular Diastolic Dysfunction by Intraventricular Dispersion of Early Diastolic Filling

BACKGROUND: Analysis of mitral flow velocity pattern provides useful variables in the assessment of left ventricular diastolic dysfuntion, but are affected by loading conditions or presence of atrial fibrillation. Thus we assessed intraventricular diastolic flow velocity profile in order to assessment of left ventricular diastolic dysfuntion. METHODS: The study population consisted of 20 subjects with normal left ventricular function(including 7 patients with atrial fibrillation only), 15 patients with hypertensive heart disease, and 14 patients with dilated cardiomyopathy. The flow velocity pattern at the mitral tip was recorded simultaneously with regional pulsed Doppler diastolic velocity patterns at 1, 2, or 3 cm from the mitral tip toward the apex. RESULTS: Inteh normal subjects, early diastolic flow velocity at the mitral tip was maintained at the positions 1 to 3cm away from the tip into the left ventricular carvity. In patients with dilated cardiomyopathy or hypertensive heart disease, peak early diastolic flow velocity decreased form the mitral tip toward the apex more progressively than in the subjects with normal left ventricular function. The same findings were obtained in selected patients group with atrial fibrillation or a normalized mitral flow velocity pattern. CONCLUSION: The assessments of the intraventricular dispersion in peak early diastolic flow velocity may be useful in detecting left ventricular diastolic dysfuntion, particularly in patients with atrial fibrillation or a normalized mitral flow velocity pattern.

A Cases of Hypertrophic Cardiomyopathy with pathologic Q Wave in EKG

HCM(=Hypertrophic Cardiomyopathy) is a primary cardiac disease and its characteristic morphologic abnormality is a hypertrophied and nondilated left ventriclar in the absence of another cardiac or systemic disease that itself is capable of producing left ventricle hypertrophy. The symptoms of HCM are varied and include dyspnea, orthopnea, fatigue, chest pain, palpitations and impaired consciousness. The pathophysiologic components of the disease process are left ventricular outlofw obstruction, diastolic dysfunction, myocardial ischemia, and arrhythmia. Predicting the clinical course and outcome for individual patients HCM has been difficult because of variability in natural history and the complexity in disease expression. The present report describe a patient with am asymptomatic, pathologic Q wave in whom HCM was diagnosed by echocardiography, MIBI-SPECT, coronary angiography, and left ventriculography.

A Case of Asymmetric Septal Hypertrophy Combined with Conn's Syndrome

We report a case of a 44 year old femele with unilateral aldosterone-proudcing adrenal adenoma characterized by hypertension, plasma aldosterone excess, and low plasma renin, commonly but not invariably with hypokalemia. She also had asymmetric septal hypertrophy of left ventricle established with two-dimensional echocardiography. The electrocardiogram showed inverted T wave and prominent U wave with high QRS voltage on precordial leads. In the case of this patient, we are not sure whether asymmetric septal hypertrophy was caused by secondary hypertension and chronic aldosterone excess of primary aldosteronism, or hypertrophic cardiomyopathy per se, so further long=term follow-up is required to determine it. Following the successful unilateral adrenalectomy, however, the systemic pressure fell down to the normal level and electrolyte abnormalities were corrected immediaterly within a few days and the modest regression in septal hypertrophy was noted in one year, suggesting that the promary aldosteronism contributes to the development or porgression of asymmetric septal hepertrophy.

A Case of Pacemaker Syndrome

Although ventricular pacing alone initially had deemed adequate for most clinical situations, some patients did not do well after ventricular pacing was initiated, and developed various symptoms attributed to this mode of pacing. The pacemaker syndrome is complex of clinical signs and symptoms related to the adverse hemodynamic and electrophysiologic consequences of ventricular pacing in the absence of other causes. Neurologic symptoms or those congestive heart failure predominated. We recently experienced a case of pacemaker syndrome in a 44-year-old female who had suffered sick sinus syndrome and was implanted with dual chamber pacing system being programmed to VVI pacing. She complained of chest discomfort, dyspnea, and near-fainting in a day after being programmed to VVI. Blood pressure was decreased to 9/60mmHg. Electrocardiography showed toPwave onT wave, representing retrograde ventriculoatrial conduction. The symptoms and signs were disappeared immediately after the pacing system was programmed to DDD pacing.

Leiomyosarcoma arising in the great saphenous vein: a case report

Though leiomyosarcoma usually occurs in the gastrointestinal tract and uterus, it rarely occurs in the wall of large veins and arteries. We present a case of primary leiomyosarcoma arising in the great saphenous vein of the left inner thigh and spreading for some extent along the vein in a 54 year old female. Diagnosis was confirmed by desmin stain and electron microscopy. Postoperative course was fine. This is the first report of this in Korean literature.

Femur neck fracture during open intramedullary nailing of femur shaft fracture: a report of one case / 대한정형외과학회잡지

No abstract available.