ABSTRACT
Eighty-one patients suffering from pulmonary stenosis with intact interventricular septum were divided into two groups according to their age: Group I (greater than 2 years), Group II (less than 2 years). In Group I, patients with RVSP up to 50 mmHg have been included in subgroup A; patients with RVSP from 50 to 90 mmHg in subgroup B, patients with RVSP greater than 90 mmHg in subgroup C. In Group II forms with RVSP less than or equal to 60 mmHg have been considered moderate and forms with RVSP greater than 60 mmHg severe. The rotation and duration of the QRS loop on the various planes, presence of a terminal slowing, the ratios 0,01"/LMSV and 0,02"/LMSV, the LMSV and the RMSV in order to assess the most significant vcgraphic parameters to predict severity of the stenosis have been analysed. A fair correlation has been found between RMSV and RVSP (r = 0,55 in Group I; r = 0,54 in Group II). The AA. conclude that a counterclockwiseloop on the H plane and the presence of a terminal slowing are the most reliable parameters for recognizing the light forms, while the clockwise loop on the H plane and a markedly increased voltage of RMSV indicate more severe stenosis.
Subject(s)
Pulmonary Valve Stenosis/congenital , Vectorcardiography , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Regression AnalysisSubject(s)
Heart Failure/prevention & control , Myocardial Infarction/complications , Adrenergic beta-Antagonists/therapeutic use , Coronary Artery Bypass , Humans , Hyperlipidemias/prevention & control , Hypertension/prevention & control , Myocardial Infarction/prevention & control , Sulfinpyrazone/therapeutic useABSTRACT
53 patients affected by congenital valvular or discrete aortic stenosis have been evaluated in order to compare the observed gradient with the one expected according to multifactorial analysis based on electrocardiographic and auscultatory data deviced by Ellison et al. There Authors employed this formula for the evaluation of the valvular form only. In our experience all cases of valvular stenosis showing an estimated gradient less than or equal to 40 mmHg were found to have a gradient less than or equal to 40 mmHg at the catheterization. This statement is true in the discrete form as well, only if the estimated gradient was less than or equal to 30 mmHg. The regression curve between the two gradients shows a r = 0.718 (p less than 0.01); an even better correlation was found in the valvular forms (r = 0.816; p less than 0.01). These results are very useful since they allow to restrict indication to catheterization only to the cases in which the obstruction is estimated to necessitate a surgical intervention.
Subject(s)
Aortic Stenosis, Subvalvular/diagnosis , Aortic Valve Stenosis/diagnosis , Cardiac Catheterization , Cardiomyopathy, Hypertrophic/diagnosis , Hemodynamics , Adolescent , Child , Child, Preschool , Electrocardiography , Female , Humans , Infant , Male , PhonocardiographyABSTRACT
A 3 month's old baby with Uhl's disease is reported. The diagnosis was made by cardiac catheterization and angiographic evaluation of right atrial and ventricular chambers and was confirmed by autopsy and histopathological examination. The particular features which allow angiographic differentiation from Ebstein's anomaly are considered. On the grounds of anatomical, clinical, and prognostic aspects, it is proposed that the definition of Uhl's anomaly be reserved for cases in infancy only, using the term Osler's disease for adult cases.
