Sixty-three patients of postinfarction left ventricular aneurysm (26 surgical cases and 37 medical cases) were analysed in the left ventricular performance, the survival rate, and the subjective complaints. In the surgical cases, the left ventricular performance improved significantly, but no significant changes were noted in the medical cases. The left ventricular function curves were inclined toward the upper left direction in the surgical cases. Whereas in the medical cases they were declined toward the lower right direction. No cardiac death occurred among the surgical cases, but it occurred in 8 patients, or 21.6% in the medical cases. Five year cumulative survival rate was 95.7% and adjusted survival rate was 100% in the surgical cases, but in the medical cases it was 80.7% and 86.8%, respectively.
Left ventricular aneurysms (LVAs) and pseudoaneurysms are two complications of myocardial infarction (MI) that can lead to death or serious morbidity.An LVA is most commonly the result of MI, usually involving the anterior wall. Other causes of LVA i
Although clinical and hemodynamic stability predicted outcome very well when left ventricular aneurysm was electively resected in 25 patients (95% survival), more discriminate criteria were essential for 20 patients undergoing urgent operation for severe myocardial decompensation (50% survival). Three methods of ventriculographic analysis primarily sensitive to the function of the non-aneurysmal left ventricle were evaluated. These methods separated patients undergoing urgent operation into a population with high operative risk (less than 18% survival) and a population with low operative risk (greater than 82% survival). These criteria also separated 15 patients undergoing operation within three months of myocardial infarction into a group with excellent prognosis (greater than 85% survival) and a group with poor prognosis (less than 15% survival). The high operative risk in patients undergoing urgent operation or operation within three months of myocardial infarction, when non-aneurysmal ...
Left Ventricular Aneurysm (Left Ventricul Wall Aneurysmal): Read more about Symptoms, Diagnosis, Treatment, Complications, Causes and Prognosis.
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TY - JOUR. T1 - Laneurisma ventricolare sinistro nellinfarto miocardico recente. Studio ecocardiografico.. AU - Pozzoli, M.. AU - Tramarin, R.. AU - Febo, O.. AU - Assandri, J.. AU - Larovere, M. T.. AU - Calsamiglia, G.. AU - Cobelli, F.. AU - Specchia, G.. PY - 1984/12. Y1 - 1984/12. N2 - Detection of post-infarction left ventricular aneurysm may have important clinical and therapeutic consequences. Differences in selection and in diagnostic criteria account for the wide range of incidence of left ventricular aneurysm in angiographic and autopsy series. To assess the incidence and related pathological features of ventricular aneurysm, 410 consecutive patients were studied by two-dimensional echocardiography 3 to 8 weeks after the onset of an acute myocardial infarction. In 395 patients (96.3%) technically adequate echograms were obtained: 42 patients (10.6%) had evidence of left ventricular aneurysm defined as a well demarcated bulge in diastole and in systole with a thinned, a-diskinetic ...
My scientific biography reflects my career as an academic cardiothoracic surgeon. Over the years I was engaged both in clinical and basic science research. In both areas I focused on topics that are close and relevant to my clinical practice. Collaboration with other disciplines was key to achieve high-quality research. The early phase of my clinical research is characterized by a series of retrospective analyses of cohorts of patients that were unique because of clinical presentation, the surgical procedure, or unusual complication. Typically these studies were single-center retrospective studies. Most of these studies included evaluation of long-term outcomes with follow-up of ten years or longer. Examples of such studies include assessment of the long-term outcome of patients undergoing allograft aortic valve replacement using various techniques (Ref. # 11, 12, 13), comparison of linear repair vs. endoaneurysmorrhaphy for left ventricular aneurysm (Ref. # 19), long term outcomes of patients ...
To the Editor:. Ouyang et al1 report on 4 patients with recurrent exercise-induced syncope attributable to fast ventricular tachycardia, aneurysms in the inferior-lateral wall of the left ventricle, and a peculiar subepicardial arrhythmogenic substrate. The authors speculate that this presentation may constitute a distinct clinical syndrome and may be amenable to epicardial catheter ablation.. A recent study has demonstrated that inflammatory left ventricular microaneurysms, often of viral origin, can be a cause of idiopathic ventricular tachyarrhythmias.2 Additionally, we recently reported a case of left ventricular microaneurysms as a cause of apparently idiopathic ventricular fibrillation in a 36-year-old woman.3. Both the study by Chimenti et al2 and our report3 provide examples of ventricular aneurysms of small dimension with different localization in the left ventricle. In contrast, the authors of the present study1 describe aneurysms that are confined to the inferior-lateral wall of the ...
Ventricular Aneurysms usually occur in the left ventricle and develop during the healing phase following a myocardial infarction. In most cases ventricular aneurysms are the result of dyskinetic, injured areas of the myocardium which do not produce tension during systole. Consequently, these areas bulge out during myocardial contraction and over time evolve into true aneurysms ...
Cineventriculography in 100 consecutive patients with coronary artery disease subjected to simultaneous coronary cine arteriography showed the presence of ventricular aneurysm in 35. All but one had either compete obstruction of one major or severe narrowing of at least two or three important vessels demonstrated by selective coronary arteriography. The presence of a ventricular aneurysm could usually be suspected during coronary arteriography by the marked sparsity, or wide separation, or both, of the arterial branches in a given site. Mural thrombus was suggested by either a filling defect or a mackerel-sky pattern. Radiological cardiomegaly was not always present; plain roentgenogram ...
Scaly circular patches - What causes non itchy red scaly circular patches on arms, legs and back, but is not psoriasis? Skin on circular patches usually hardens and falls off Please see. Please see your dermatologist for evaluation and to discuss treatment options. Its not possible to tell because there are many diseases that look the same.
Postoperative left ventricular pseudoaneurysm is a rare, but potentially lethal, complication because of the high risk of rupture and high mortality of repair. We report a 64-year-old man with Marfan syndrome who underwent the reimplantation valve-sp
Newer multimodality imaging may help uncover unique ventricular morphology that might be consistent with unrecognized forms of possible cardiomyopathies (1-3). We describe one such possibility in a 52-year-old man with chronic atypical chest pain and no prior cardiac history who had a fixed anterior defect on a stress myocardial perfusion single-photon emission computed tomography. Coronary angiography revealed normal epicardial arteries without evidence of atherosclerotic lesions, luminal stenosis, thrombus, or dissection but a left ventricular angiogram (Fig. 1,Online Video 1) showed an unusual appearance, with a large left ventricular aneurysm and multiple small-to-moderate size diverticula with surrounding areas of prominent trabeculation of the basal anterior, apical and basal, and mid-inferior walls. Cardiac magnetic resonance (Online Videos 2 and 3) confirmed the presence of a large mid-distal anterior and anteroseptal wall aneurysm with a relatively narrow neck surrounded by thinned ...
Case from: Henning Clausen, Vanessa Ferreira, Stefan Neubauer, Cameron J. Holloway. Institute: University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), John Radcliffe Hospital, Headington, Oxford, United Kingdom Clinical history: A 69-year-old male with a history of previous myocardial infarction developed increasing exertional dyspnoea and angina four years after initial presentation. Coronary angiography revealed chronic occlusion of the right coronary artery. There was significant stenosis of the left anterior descending artery, which was successfully treated by percutaneous coronary intervention using two drug eluting stents. Left ventriculography showed a possible aneurysm in the basal inferior wall in keeping with previous infarction. There was no history of stroke during follow-up, but gradual deterioration of exercise tolerance and difficult transthoracic echocardiography windows prompted referral for cardiac magnetic resonance (CMR) ten years after initial infarction ...
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An atrial septal aneurysm is an atrial septum that is bulging, abnormally enlarged and mobile, explains About.com. The atrial septum is the membrane that separates the upper chambers of the heart....
Welcome to the ValueMD Albums. Cardiac CT. Images: Normal and Anomalous Coronary Arteries: Dual Source CT in Cardiothoracic Imaging, Coronary Anatomy, CT aorta, Aortic Stenosis, Left ventricular aneurysms are discrete, dyskinetic areas of the left ventricular (LV) wall with a b
Coronary heart disease (CHD) and stroke frequently coexist, partly because they share many risk factors. After myocardial infarction (MI), there is a significant risk of mural thrombus formation, left ventricular aneurysm, impaired left ventricular function and atrial fibrillation; all these increase the risk of stroke. The risk of neurological deficit after cardiac surgery is higher in those patients who have already had a stroke. Cognitive decline after cardiac surgery is common: it may follow a pattern of early improvement but later decline. Lipid-lowering therapy has been shown to reduce non-fatal stroke in patients at risk of developing or with coronary artery disease. Clopidogrel with aspirin may be of benefit in patients with unstable angina and non-ST elevation MI. Antihypertensive treatment and stopping smoking are helpful. The HOPE trial results showed a powerful and preventative role for ACE inhibitors.. ...
Chapter 7 Confusing Conditions: ST-Segment Elevations and Tall T-Waves (Coronary Mimics) Key Points Not all ST-segment elevations signify an acute myocardial infarction. Indeed, noncoronary ST-segment elevations are common. Many such patients have diagnoses other than acute STEMI, most often left ventricular hypertrophy (LVH), left bundle branch block (LBBB), left ventricular aneurysm, pericarditis or the early…
These ECGs are unfortuantely an excellent example of the progression to "LV aneurysm morphology" (see below for reference). The ECG will likely remain similar to the above indefinitely. It is critical to recognize this morphology as this patient is at highest possible risk for the classic complications of transmural infarction including anatomic LV aneurysm, mural thrombus with subsequent stroke, free wall rupture, VSD, Dresslers syndrome, etc. He is also at risk of another complication that gets less discussion: misdiagnosis of his new baseline ECG! He will likely have persistent STE which will be alarming to his future providers, yet the T-waves will likely be the most reliable electrocardiographic feature to tell us whether he is experiencing further acute coronary occlusion affecting his anterior wall. He is at risk of mismanagement in both directions. Should he unfortunately suffer a pulmonary embolism or pericarditis or simply GERD or chest wall pain, for example, he may present with ...
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I am a 54 y.o. R.N. w/ a HX of Heart Failure in 5/2005-EF 20% @ that time. Concurrent Diagnosis of Idiopathic Dilated Cardiomyopathy (all new diagnoses at that time). Treated w/ standard HF protocol me...
DI-fusion, le Dépôt institutionnel numérique de lULB, est loutil de référencementde la production scientifique de lULB.Linterface de recherche DI-fusion permet de consulter les publications des chercheurs de lULB et les thèses qui y ont été défendues.
In small infants, when an apical-aortic conduit is required, there may be inadequate space in which to work to attach the conduit to the descending aorta when
The acute ECG (first one at top) clearly shows the previous MI (Q-waves). The T-waves are upright. Is this pseudonormalization? No. Over weeks to months and certainly years, inverted T-waves of MI normalize as part of the natural history of the ECG in MI (Although, in LV aneurysm, they often remain with shallow invertion). So before this acute event the T-waves were likely upright ...
Porn star Ron Jeremy is reportedly in critical condition and in the Intensive Care Unit of a California hospital after suffering a heart
PA upright chest - there is an area of lucency noted in the apical left lung above a well-defined pleural line that is devoid of pulmonary vasculature.
A 47-year-old woman presented with paroxysmal atrial flutter. Echocardiogram and computed tomography with 3-dimensional reconstruction revealed a massive right atrium (RA) with a giant aneurysm of the right atrial appendage and patent foramen ovale (PFO) (A). AO = aorta; RV = right ventricle.. Surgery was performed with a minimally invasive, video-assisted thoracoscopy, cardiopulmonary bypass, and cardioplegic arrest. After peripheral cannulation, the thoracic cavity was entered through a 3-cm inframammary incision in the fourth intercostal space. The right atrium and appendage were grossly enlarged and thinned out with a transition margin to normal atrium circumferentially. The diseased atrium was excised (B), the PFO closed, and a right-sided cryo-maze for atrial flutter ablation was performed (Online Video 1). The patient recovered uneventfully and was discharged after 3 days.. Right atrial aneurysm is a rare anomaly. Indications for resection include atrial arrhythmias or thrombus formation. ...
This ECG is typical not of acute inferior STEMI, but of old, or at least subacute STEMI: the T-waves are inverted and there are well-formed Q-waves. What about reciprocal ST depression in aVL? This is seen both in acute inferior STEMI and in "old inferior MI with persistent ST elevation," also known as "LV aneurysm morphology." For this reason, these two entities can be very difficult to differentiate. We have discussed anterior LV aneurysm frequently in the past. Though both have ST elevation, Anterior STEMI and anterior aneurysm are much easier to differentiate ...
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The technology of both modalities is rapidly evolving, and although CMR is becoming more widely available, the availability of miniaturized systems has made echocardiography ubiquitous. As is always the case, both viewpoints in this iForum are correct. We should not lose sight of the fact that the main burden of HF is in the community. The primary goal of the initial test is, therefore, to categorize patients according to whether they have HF with impaired or preserved function; this information determines therapy and is probably the reason that imaging has been shown to have an effect on outcome (7) and hemodynamics. Echocardiography is unmatched in its ability to assess cardiac physiology in the clinical setting. It is the only widely available technique that allows accurate noninvasive estimation of left atrial and pulmonary arterial pressures. Both tests are able to evaluate complications of HF such as intracardiac thrombus, LV aneurysm, and valve dysfunction. Echocardiography remains the ...
This study provides new data concerning the performance of current imaging strategies, as well as utility of a novel approach (predicated on a routine echo) for post-MI LV thrombus. There were several key findings. First, LV thrombus remains an important diagnostic issue in the current reperfusion era. Among the broad post-MI population studied, thrombus was present in 8% of all patients, including 15% of those with LAD infarction. Second, although generally associated with adverse remodeling, markedly depressed EF (≤30%) on echo occurred in only 12% of patients with thrombus, and only 18% had an LV aneurysm. Third, despite tailored imaging with uniform contrast administration, echo remained limited as a solitary strategy for post-MI thrombus. Noncontrast echo yielded a diagnostic sensitivity of 35% compared with the reference DE-CMR. Although use of contrast improved echo image quality and sensitivity (64%), one-third of DE-CMR-evidenced thrombi were missed. Fourth, thrombus was strongly ...
Ethylnorepinephrine (Etanor, Bronkephrine, Butanefrine) is a sympathomimetic and bronchodilator related to norepinephrine. It activates both α and β adrenergic receptors. Norepinephrine David J. Triggle (1996). Dictionary of Pharmacological Agents. Boca Raton: Chapman & Hall/CRC. ISBN 0-412-46630-9. KORNEL L (1958). "A case of calcified ventricular aneurysm with progressive heart block; observations on the effect of ethylnorepinephrine". Cardiologia. 32 (2): 101-9. doi:10.1159/000165806. PMID 13500349. CHRISTENSEN JM, VALASEK FE, TAINTER ML (June 1958). "Ethylnorepinephrine; a unique bronchodilator". American Practitioner and Digest of Treatment. 9 (6): 916-21. PMID 13533786. Turner, Robert A. (1965). "12. Sympatholytic Agents. VI. The Two Kinds of Receptors". Screening Methods in Pharmacology. 111 Fifth Avenue, New York, New York 10003: Academic Press Inc. p. 150. ISBN 1483255913 ...
We will present the case of a 52 year old patient, admitted to our Department for exertional angina, with 2 recent acute events--inferior myocardial infarction and stroke. The coronary angiography revealed patent coronary arteries, without atheroscle
HSP(42) was an experimental effort to determine whether the quantal nature of light energy transfer to visual pigment molecules had implications for vision. They developed an experimental model of a human observer detecting a small, briefly flashed target imaged under night vision conditions: the target was flashed for 1 ms on a circular patch of the peripheral retina subtending ∼500 rod photoreceptors. In the model, an observer is hypothesized to detect the target if some criterion minimum number of photons is captured. For 7 observers in 25 different sessions, the average threshold (arbitrarily defined as the light intensity giving rise to 60% detection) was 92 quanta. Physics dictates that the actual number of photons captured on any given trial using a flash of nominally fixed intensity will be a Poisson random variable. The "frequency of seeing" curve, which plots the fraction of trials in which light was seen at a given light intensity in a series of flashes, therefore can be derived ...
Detailed information about lyme disease, red circular patches on skin, skin rashes, the symptoms, causes, treatments, prevention and skin care.
Detailed information about lyme disease, red circular patches on skin, skin rashes, the symptoms, causes, treatments, prevention and skin care.
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As mortal as I suddenly feel, Im hardly ready to turn in my binoculars. Jack Kerouac wrote, "Why think about that when all the golden lands ahead of you and all kinds of unforeseen events wait lurking to surprise you and make you glad youre alive to see?" Im getting a puppy in two weeks, and looking forward to having her in my life has definitely given my days a luster of gold. It had never even occurred to me when I arranged to get her on the day she was born, January 2, that it might be possible Id not outlive her. Ironically, Im actually less likely to suffer a heart attack now that Im on blood thinners than I was before we knew I had a congenital aneurism in a coronary artery. Yet, regardless of statistics, I have an unsettling, visceral sense of my eventual demise that Id never felt before-a feeling that will be forever reinforced by the little vial of nitroglycerin Im supposed to keep with me at all times, prescribed by the same professionals who say my chances are excellent that ...
Upper panel from an echo in Jan 2010 using a system without a dedicated contrast preset, the contrast acquisition was done simply by lowering the MI, the contrast image is diagnostic but clearly lacking the quality of the contrast image in the lower panel (Feb 2011) from the same patient using a low-MI contrast presetting. In the latter one can clearly get more information; a small apical aneurysm and decreased endocardial perfusion is apparent.. ...
We illustrate a case of midventricle obstructive HCM and apical aneurysm diagnosed with appropriate use of multimodality imaging. A 75-year-old African American woman presented with a 3-day history of chest pain and dyspnea with elevated troponins. Her electrocardiogram showed sinus rhythm, left atrial enlargement, left ventricular hypertrophy, prolonged QT, and occasional ectopy. After medical therapy optimization, she underwent coronary angiography for an initial diagnosis of non-ST segment elevation myocardial infarction. Her coronaries were unremarkable for significant disease but her left ventriculogram showed hyperdynamic contractility of the midportion of the ventricle along with a large dyskinetic aneurysmal apical sac. A subsequent transthoracic echocardiogram provided poor visualization of the apical region of the ventricle but contrast enhancement identified an aneurysmal pouch distal to the midventricular obstruction. To further clarify the diagnosis, cardiac magnetic resonance imaging with
Results The mean age was 49.8 years and female was dominant (10 patients). The saccular pattern showed in 3 cases (25%) and blister type was 9 cases (75%). In saccular type, only 1 case used stent (33%). In blister type, all cases performed stent assist coiling. The average number of stent was 2.67. The earlier 4 case (2010-2011) and later 5 cases (2012-2014) showed average 1.5 stents with loose packing density and average 3.2 stents with dense one, respectively. In saccular group of 3 cases, the modified Rankin scales at 6 month were 0, 0 and 6 (brain edema). In blister group of 9 cases, those were 0 (6 cases; 67%), 2 (1 case; 8.3%) and 4 (2 cases; 16.7%). The earlier 4 cases showed poor outcome compared to later group, but the number of stent and coil packing density did not correlated with final outcome. ...
93 patients had CMR for suspected CES, revealing 9 thrombi in n = 9 (9.7%) patients. The thrombi were located in the LAA (n = 3), left ventricle (n = 4) and right atrial appendage (n = 3). Of these 9 patients echocardiography was positive in n = 2 (22%), indeterminate in n = 2 (22%) and negative in n = 5 (56%) (Figure 1). No thombi were detected echocargraphy that were not seen on CMR. CMR reported 103 non thrombotic additional findings in n = 53 (57%) of patients compared to echocardiography. Sixty of these were considered significant in n = 38 (40.9%) of patients. Additional findings associated with thrombus formation (acute infarction, scarring and LV aneurysms) were n = 19 (20%) for CMR and n = 7 (7%) for echocardiography. In the n = 9 patients with positive CMR and either false negative (n = 5) or indeterminate (n = 2) echocardiography, secondary preventive therapy changed from antiplatlet agents to anticoagulants (warfarin or heparin) in n = 4 (44%). Presumed stroke mechanism, changed in 3 ...
Chagas disease is caused by a protozoan parasite, Trypanosoma cruzi, that is transmitted to humans through the feces of infected bloodsucking insects in endemic areas of Latin America, or occasionally by nonvectorial mechanisms, such as blood transfusion. Cardiac involvement, which typically appears decades after the initial infection, may result in cardiac arrhythmias, ventricular aneurysm, congestive heart failure, thromboembolism, and sudden cardiac death ...
Another option for treatment is ultrasound probe compression of the neck of the pseudoaneurysm. The "neck" of the pseudoaneurysm is the narrow path of blood flow between the artery, through the arterial wall, and into the pseudoaneurysm cavity. The artery, neck, and pseudoaneurysm are seen on ultrasound. The ultrasound probe can be pushed firmly against the patients skin to compress the neck of the pseudoaneurysm for usually about 20 minutes. During this time, the blood within the pseudoaneurysm clots; after the probe is then removed, the pseudoaneurysm will hopefully remain clotted and will not continue to expand. The procedure may be stopped early due to patient discomfort. It is less successful if the patient is obese, since there is more fatty tissue between the skin and the neck of the pseudoaneurysm. It also is less successful if the neck of the pseudoaneurysm is wider, since it is less likely to clot off during the period of compression. Finally, it is also much less successful if the ...
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Apical Aneurysm - Right Ventricle & Atrial Flutter & Tricuspid Valve Insufficiency Symptom Checker: Possible causes include Cardiomyopathy. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search.