Subject(s)
Echocardiography, Doppler , Pericarditis, Constrictive/diagnostic imaging , Blood Flow Velocity , Cardiomyopathy, Restrictive/diagnostic imaging , Diagnosis, Differential , Hepatic Veins/diagnostic imaging , Hepatic Veins/physiopathology , Humans , Mitral Valve/diagnostic imaging , Mitral Valve/physiopathology , Pericarditis, Constrictive/physiopathology , Pulmonary Veins/diagnostic imaging , Pulmonary Veins/physiopathology , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/physiopathologySubject(s)
Aortic Diseases/diagnostic imaging , Echocardiography , Embolism/diagnostic imaging , Heart Diseases/diagnostic imaging , Thrombosis/diagnostic imaging , Aortic Diseases/etiology , Echocardiography/methods , Embolism/etiology , Esophagus , Female , Heart Atria/diagnostic imaging , Heart Diseases/complications , Humans , Middle Aged , Thrombosis/complicationsABSTRACT
Doppler ultrasound recordings of velocities of flow across the mitral and tricuspid valves and in the hepatic veins, and their variation with respiration, were recorded in seven patients with constrictive pericarditis and in six patients with restrictive cardiomyopathy. Deceleration of mitral and tricuspid flow was also evaluated during apnea. Color flow Doppler was performed in order to evaluate mitral and tricuspid regurgitation. Eight healthy adults served as controls. The patients with constrictive pericarditis showed higher peak diastolic velocities of mitral flow, as well as marked increase of velocity of flow at the onset of expiration and decrease at the onset of inspiration. Reciprocal respiratory variation of the velocities were also observed across the tricuspid valve. The patients with restrictive cardiomyopathy showed moderate or severe mitral and tricuspid regurgitation. They also showed shorter deceleration of flow across the mitral and tricuspid valves during apnea. The pattern of flow in the hepatic veins showed reversal during systole with accentuated reversion during inspiration. These results suggest that patient with constrictive pericarditis and restrictive cardiomyopathy can be differentiated by comparing Doppler echocardiographic data, along with changes induced by respiration.
Subject(s)
Cardiomyopathy, Restrictive/diagnostic imaging , Pericarditis, Constrictive/diagnostic imaging , Adult , Aged , Blood Flow Velocity , Cardiomyopathy, Restrictive/pathology , Cardiomyopathy, Restrictive/physiopathology , Diagnosis, Differential , Echocardiography, Doppler , Female , Hepatic Veins/diagnostic imaging , Hepatic Veins/physiopathology , Humans , Male , Middle Aged , Mitral Valve/diagnostic imaging , Mitral Valve/physiopathology , Pericarditis, Constrictive/pathology , Pericarditis, Constrictive/physiopathology , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/physiopathologyABSTRACT
The aim of our study was to assess the ability of echocardiography to recognize mediastinal masses. We studied 50 patients: 25 with acute lymphoblastic leukemia, nine with lymphomas, four with pleural effusion and previously known neoplastic diseases, ten with nonlymphomatous mediastinal masses, and two with compression of the superior vena cava. In 33 of 50 patients, computed tomography (CT) showed mediastinal masses, and in one, an aneurysm of the thoracic descending aorta. All patients had previously had chest x-ray and two-dimensional echocardiographic (2-DE) examinations in order to recognize the presence of masses. Two-DE was found to have similar specificity (94.1 percent) but higher sensitivity (90.9 percent vs 60.6 percent) if related to radiographic examination. The positive predictive value was 96.7 vs 95.2 percent and the negative predictive value was 84.2 percent vs 55.1 percent. In particular, 2-DE was more useful than chest x-ray examination when a concomitant pleural or pericardial effusion was present. Moreover, abnormalities of cardiac function due to compression or infiltration and the follow-up of patients were better evaluated.
