[Atrial myxoma with clinical signs of systemic inflammatory disease]. / Vorhofmyxom mit klinischem Bild einer entzündlichen Systemerkrankung.

Atrial myxomas are detectable in 0.3 % of all autopsies and women are affected three times more often than men. The overall incidence of myxoma is relatively rare with 0.5 per one million inhabitants per year. Clinical signs, such as palpitations, dyspnea, dizziness and syncope or thromboembolic events may be found. Microembolic infarction or a higher expression of interleukin 6 may lead to misdiagnosis, such as vasculitis. This article presents the case of a 25-year-old woman with arthralgia, dysesthesia, staggering vertigo, cutaneous nodules and disturbed vision. Diagnostic procedures did not reveal a reason for these complaints. A therapeutic test with prednisolone did not improve the symptoms. Finally echocardiography showed a large space-occupying lesion in the left atrium which oscillated into the left ventricle during diastole. The patient was transferred to the department of cardiac surgery where the atrial myxoma could be removed without any complications and the patient ultimately made a complete recovery.

The accuracy of experimentally determined angiographic right ventricular volume.

The purpose of this investigation was to validate in vivo the accuracy of videoangiocardiographic right ventricular volume determination. Thus the stroke volume of the right ventricle as difference of enddiastolic and endsystolic volume was determined simultaneously (n = 70) by videoangiocardiography and with an electromagnetic flowmeter in 7 open-chested pigs with an average weight of 18.5 kg. Model volumes, calculated with the multiple slices and the area-length methods on the basis of mono- and biplane angiographic right ventricular projections, were corrected conventionally and with factors appropriate for cardiac phase and spatial orientation. The correlation between electromagnetic and angiographic stroke volume was the lowest (r = 0.802) when monoplane and highest (r = 0.949) when biplane methods were used. A systematic error could be prevented (y = -0.3 + 1.0 x; Syx = +/- 1.96 ml) by applying correction factors appropriate for cardiac phase and spatial orientation. The statistical error was independent of the correction used. The correlation coefficient for the optimal corrected monoplane method based on the lateral projection was r = 0.861 and for the ap plane r = 0.930. Right ventricular stroke volume can be determined videoangiocardiographically without systemic error and with an acceptable statistical error, if spatial orientation and cardiac phase are considered. If only monoplane equipment is available, the approjection is preferable.