ABSTRACT
One hundred thirty-six patients underwent radionuclide ventriculography as part of an evaluation prior to bone marrow transplantation. One hundred twenty-six who were considered suitable transplant candidates began conditioning chemotherapy or chemoradiotherapy and were retrospectively evaluated for development of cardiac toxicity. The cumulative pretransplant anthracycline dose in patients who began the conditioning regimen was not a significant predictor for decreased pretransplant ejection fraction (EF) or severe cardiac toxicity following transplantation. Fourteen patients (10%) had EFs less than 50%. Of these, 10 began the preparative regimen and two (20%) experienced grade III or IV cardiac toxicity (95% confidence interval (CI) 2.5-56%) versus five of 116 patients (4%; CI 1.4-9.8%) with EFs greater than or equal to 50% (p = 0.096). The incidence of grade III or IV cardiac toxicity among patients with any history of cardiac dysfunction or with an abnormal physical examination prior to transplant was 9% (two of 22) versus 5% among the remaining patients (five of 104) (p = 0.605). Though transplant-related cardiac toxicity may be more common in patients with mildly reduced EFs, the small number of patients with reduced EFs referred for transplant does not warrant the routine pretransplant screening of all patients with radionuclide ventriculography.
Subject(s)
Antibiotics, Antineoplastic/adverse effects , Cyclophosphamide/adverse effects , Heart/drug effects , Premedication , Stroke Volume , Adolescent , Adult , Bone Marrow Transplantation/methods , Chi-Square Distribution , Child , Child, Preschool , Gated Blood-Pool Imaging , Heart/diagnostic imaging , Humans , Infant , Middle Aged , Retrospective Studies , Risk FactorsABSTRACT
Acardiac monster represents a rare but serious complication of monozygotic twin pregnancy. Antenatal recognition is important because of accompanying obstetrical problems, including polyhydramnios, dystocia, and uterine rupture. While pathologic findings are varied, characteristic sonographic findings allow accurate prenatal diagnosis. Acardia must be distinguished from sacrococcygeal teratoma, omphalocele and macerated fetus.
Subject(s)
Abnormalities, Severe Teratoid/diagnostic imaging , Heart Defects, Congenital/diagnostic imaging , Pregnancy, Multiple , Twins, Monozygotic , Ultrasonography, Prenatal , Abnormalities, Multiple/diagnostic imaging , Abnormalities, Multiple/pathology , Abnormalities, Severe Teratoid/pathology , Adult , Diseases in Twins , Female , Heart Defects, Congenital/pathology , Humans , Infant, Newborn , Male , PregnancyABSTRACT
Scintigrams obtained 24 and 48 hours after the injection of 67Ga in a patient undergoing evaluation for fever of unknown origin revealed positive myocardial uptake. The subsequent clinical course, electrocardiograms, radionuclear studies, and postmortem examination confirmed a silent myocardial infarction in the region of 67Ga localization. No other clinical reports were found of an acute myocardial infarction diagnosed by scintigraphy with 67Ga.
