Marfan s Disease: Tricuspid and Mitral Valve Insufficiency with a Normal Aortic root
|
|
- Pierce Leonard
- 6 years ago
- Views:
Transcription
1 Case Reports Marfan s Disease: Tricuspid and Mitral Valve Insufficiency with a Normal Aortic root Jacques Heibig, MD, FACC, FCCP,* Charles Robinson, MD, FRCP(C) and Mohammed E. Fawzy, MB, MRCP* * Consultant Cardiologists, Department of Medicine; Pathologist, Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre J Heibig, C Robinson, ME Fawzy, Marfan s Disease: Tricuspid and Mitral Valve Insufficiency with a Normal Aortic root. 1983; 3(3): KEYWORDS: Arachnodactyly, Mitral valve insufficiency, Tricuspid valve insufficiency Introduction Marfan's disease is am hereditary tissue disorder that is transmitted as an autosomal dominant trait with a variable degree of expression. In its most complete form, it is a syndrome characterized by skeletal, ocular, and cardiovascular abnormalities, as described by McKunsick and others. 1,3 Cardiovascular abnormalities are the most common causes of death, and aortic root disease is frequently encountered. 4,5 Isolated mitral and tricuspid valve involvement without associated aortic root disease is not unique but of sufficient rarity to merit recording. Case Report A 20-year-old male was referred to King Faisal Specialist Hospital after having been diagnosed elsewhere as having rheumatic heart disease. He presented with fatigue and dyspnea and was graded functional class IV according to the New York Heart Association Classification. A heart murmur was noted a few months earlier but there was no history to suggest rheumatic fever. Several memberss of the family had clinical evidence of Marian's disease. Clinical examination confirmed the typical features of the Marfan syndrome. The arm span was 1.84 meters and the height 1.72 meters. Arachnodactyly was present and the patient had a high arched palate and pectus carinatum. There was a positive "thumb sign". 3 The lenses of both eyes were dislocated upwards. The arterial blood pressure was 90/660 mm Hg; the jugular venous pressure was elevated at 15 cm of water and displayed a prominent V wave with a rapid Y descent. The arterial pulses were all present bout of low amplitude; the pulse rate was 100/min. The left ventricular thrust was hyperkinetic and deviated 2 cm to the left of the midclavicular line. There was a pansystolic murmur at the apex, grade III/VI, which was propagated to the left axilla. A different systolic murmur, increasing with inspiration, was also heard. A loud ventricular gallop was heard over the entire precordium. The liver was moderately enlarged, tender, and pulsatile. No murmur indicative of aortic valve incompetence could be heard. The ECG showed left atrial enlargement and combined right and left ventricular hypertrophy (Figure 1). The chest radiograph showed a markedly enlarged heart (Figure 2). The M-mode echocardiogram showed left and right ventricular volume overload and pansystolic prolapse of both mitral and tricuspid valves; the aortic root dimension was normal (Figure 3). Results of routine laboratory investigations were normal. Hemodynamic data indicated severe tricuspid and mitral valve incompetence, absence of end-diastolic gradient across both valves, and pulmonary hypertension. The left ventricular angiogram showed severe mitral valve insufficiency and left ventricular volume overload with increased volume in systole and diastole (Figure 4). The aortic angiogram was normal; in particular, there was no sign of aortic valve insufficiency and the aortic root dimension was normal. Because heart failure was not responsive to intensive medical therapy, both mitral and tricuspid valves were replaced with prosthetic devices. The patient did relatively well following surgery but died a few days later because of a low cardiac output syndrome. Pathology The valves appeared grossly to be "myxoid" and the chordae tendineae were stretched and thinned (Figure 5), but according to the surgical records they had not ruptured. Microscopically there was widespread fragmentation of
2 the elastic fibers and in the most myxoid areas, elastic fibers were absent (Figure 6). The zona spongiosa was prominent, with an extensive layer of myxomatous tissue that had replaced the fibrosa. The myxomatous change extended to the deformed surface and there was fibrosis of the holding surface. The stains used to demonstrate acid mucopolysaccharides were alcian blue at ph 2.5 and the colloidal iron stain. Both mitral and tricuspid valves showed striking myxoid degeneration (Figure 7). The H&E stain showed numerous bland nuclei separated by loose myxoid tissue. There was neither vascularity nor inflammation and no evidence of bacterial vegetation. Figure 1. Twelve-lead electrocardiogram showing combined left and right ventricular hypertrophy. Figure 2. Posteroanterior chest radiograph demonstrating the enlarged cardiac silhouette.
3 Figure 3. M-mode echocardiogram. Sweep from the aortic root to the left ventricular cavity demonstrating the normal site of the aortic root, the enlarged LA and LV cavities, and the pansystolic prolapse of mitral valve. Figure 4. Left ventricular angiogram in the right anterior oblique position showing severe mitral valve incompetence. A portion of left auricular appendage showed normal muscle, endocardium and subendocardial tissues. Discussion Based on necropsy material, Roberts and Honig have classified the findings in 18 adults with the Marfan syndrome into three groups. 5 Group 1 had a fusiform ascending aorta with marked elastic fiber degeneration. The aortic and mitral valves were "stretched" or prolapsed and showed increased acid mucopolysaccharide. Group 2 had aortic dissection with no prior valve insufficiency. Group 3 consisted of two patients who had floppy prolapsed mitral valves with markedly dilated mitral annuli but a normal aorta and aortic valve. Analysis of 151 previously reported necropsies on Marfan patients found that 22 percent had an isolated or a predominant mitral regurgitation;
4 in these, mitral valve dilatation with or without leaflet prolapsed appeared to be the major cause of mitral regurgitation. 5 These necropsy findings are consistent with clinical studies such as that of Pyeritz et al., showing that in 50 consecutive patients with typical Marfan syndrome, 84 percent had aortic root enlargement demonstrated by M-mode echocardiography and 6 percent were found to have a murmur indicative of mitral valve regurgitation only. 3,6 Figure 5. Stretched and thinned chordae tendineae. Figure 6. Fragmented elastic fibers of mitral valve.
5 Figure 7. Myxoid degeneration in tricuspid valve (colloidal iron stain). The present case might thus fall into Roberts and Honig's group 3. Apart from the unusual involvement of the tricuspid valve, 7,8 the main feature of interest in our case is the apparent complete lack of involvement of the aortic valve and aortic root. Unfortunately, necroscopy was not obtained but visual inspection at surgery indicated lack of aortic disease. It is, however, possible that there was microscopic evidence of Marfan stigmata of both the aortic valve and aorta. REFERENCES 1. Payvandi MN, Kerber RE, Phelps C, et al.: Cardiac, skeletal and opthalmologic abnormalities in relatives of patients with the Marfan syndrome. Circulation 55(5): Hirst AE Jr, Gore I: Marfan's syndrome: a review. Prog Cardiovasc Dis 16: Pyeritz RE, McKusick VA: The Marfan syndrome: diagnosis and management. TV Engl J Med 300(14): / Murdoch JL, Walker BA, Halpern BL, et al.: Life expectancy and causes of death in the Marfan syndrome. N Engl J Med 286: Roberts WC, Honig HS: The spectrum of cardiovascular disease in the Marfan Syndrome: a clinico morphologic study of 18 necroscopy patients and comparison to 151 previously reported necrospy patients. Am Heart J 104(1): McKusick VA: The cardiovascular aspects of Marfan's syndrome: a heritable disorder of connective tissue. Circulation 11(3): Shankar KR, Hultgren MK, Lauer RM, et al.: Lethal tricuspid and mitral regurgitation in Marfan's syndrome. Am J Cardiol 20: Saponaro A, Russo R, Dragagna G, et al.: Insufficienza mitralica isolata nella sindrome di Marfan completa. Minerva Cardioangiol 24(5):
Mitral Regurgitation in a Patient with the Madan Syndrome
Mitral Regurgitation in a Patient with the Madan Syndrome I BERNARD SEGAL, M.D.,* HRATCH KASPARIAN, M.D.,** AND WILLIAM LIKOFF, M.D., F.C.C.P,t N 1896, MARFAN DESCRIBED THE GROSS skeletal manifestations
More informationBy the end of this session, the student should be able to:
Valvular Heart disease HVD By Dr. Ashraf Abdelfatah Deyab VHD- Objectives By the end of this session, the student should be able to: Define and classify valvular heart disease. Enlist the causes of acquired
More informationHISTORY. Question: How do you interpret the patient s history? CHIEF COMPLAINT: Dyspnea of two days duration. PRESENT ILLNESS: 45-year-old man.
HISTORY 45-year-old man. CHIEF COMPLAINT: Dyspnea of two days duration. PRESENT ILLNESS: His dyspnea began suddenly and has been associated with orthopnea, but no chest pain. For two months he has felt
More informationThe production of murmurs is due to 3 main factors:
Heart murmurs The production of murmurs is due to 3 main factors: high blood flow rate through normal or abnormal orifices forward flow through a narrowed or irregular orifice into a dilated vessel or
More informationValvular Heart Disease
Valvular Heart Disease MITRAL STENOSIS Pathophysiology rheumatic fever. calcific degeneration, malignant carcinoid disease, congenital mitral stenosis. SLE. The increased pressure gradient across the mitral
More informationSarah J. Miller, DVM, Diplomate ACVIM (Cardiology) Degenerative Valvular Disease What s New?
Sarah J. Miller, DVM, Diplomate ACVIM (Cardiology) Degenerative Valvular Disease What s New? Chronic degenerative valvular disease is the most common cardiovascular disease in small animals, and is also
More informationWhat Is Valvular Heart Disease? Heart valve disease occurs when your heart's valves do not work the way they should.
What Is Valvular Heart Disease? Heart valve disease occurs when your heart's valves do not work the way they should. How Do Heart Valves Work? MAINTAIN ONE-WAY BLOOD FLOW THROUGH YOUR HEART The four heart
More informationMitral Valve Disease. Prof. Sirchak Yelizaveta Stepanovna
Mitral Valve Disease Prof. Sirchak Yelizaveta Stepanovna Fall 2008 Mitral Valve Stenosis Lecture Outline Mitral Stenosis Mitral Regurgitation Etiology Pathophysiology Clinical features Diagnostic testing
More informationThe production of murmurs is due to 3 main factors:
Heart murmurs The production of murmurs is due to 3 main factors: high blood flow rate through normal or abnormal orifices forward flow through a narrowed or irregular orifice into a dilated vessel or
More informationHISTORY. Question: What category of heart disease is suggested by this history? CHIEF COMPLAINT: Heart murmur present since early infancy.
HISTORY 18-year-old man. CHIEF COMPLAINT: Heart murmur present since early infancy. PRESENT ILLNESS: Although normal at birth, a heart murmur was heard at the six week check-up and has persisted since
More informationMITRAL VALVE DISEASE- ASSESSMENT AND MANAGEMENT. Irene Frantzis P year, SGUL Sheba Medical Center
MITRAL VALVE DISEASE- ASSESSMENT AND MANAGEMENT Irene Frantzis P year, SGUL Sheba Medical Center MITRAL VALVE DISEASE Mitral Valve Regurgitation Mitral Valve Stenosis Mitral Valve Prolapse MITRAL REGURGITATION
More informationTSDA Boot Camp September 13-16, Introduction to Aortic Valve Surgery. George L. Hicks, Jr., MD
TSDA Boot Camp September 13-16, 2018 Introduction to Aortic Valve Surgery George L. Hicks, Jr., MD Aortic Valve Pathology and Treatment Valvular Aortic Stenosis in Adults Average Course (Post mortem data)
More informationHistorical perspective R1 黃維立
Degenerative mitral valve disease refers to a spectrum of conditions in which morphologic changes in the connective tissue of the mitral valve cause structural lesions that prevent normal function of the
More informationCase 47 Clinical Presentation
93 Case 47 C Clinical Presentation 45-year-old man presents with chest pain and new onset of a murmur. Echocardiography shows severe aortic insufficiency. 94 RadCases Cardiac Imaging Imaging Findings C
More informationCongenital Heart Disease Cases
Congenital Heart Disease Cases Sabrina Phillips, MD FACC FASE Mayo Clinic Congenital Heart Disease Center 2013 MFMER slide-1 No Disclosures 2013 MFMER slide-2 1 CASE 1 2013 MFMER slide-3 63 year old Woman
More informationFor more information about how to cite these materials visit
Author: Michael Shea, M.D., 2008 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike 3.0 License: http://creativecommons.org/licenses/by-sa/3.0/
More informationMarfan syndrome affecting four generations of a family without ocular involvement
Postgrad Med J (1991) 67, 538 542 The Fellowship of Postgraduate Medicine, 1991 Marfan syndrome affecting four generations of a family without ocular involvement A.B. Bridges, M. Faed', M. Boxer', W.M.
More informationTricuspid and Pulmonic Valve Disease
Chapter 31 Tricuspid and Pulmonic Valve Disease David A. Tate Acquired disease of the right-sided cardiac valves is much less common than disease of the leftsided counterparts, possibly because of the
More informationPROSTHETIC VALVE BOARD REVIEW
PROSTHETIC VALVE BOARD REVIEW The correct answer D This two chamber view shows a porcine mitral prosthesis with the typical appearance of the struts although the leaflets are not well seen. The valve
More informationClinical significance of cardiac murmurs: Get the sound and rhythm!
Clinical significance of cardiac murmurs: Get the sound and rhythm! Prof. dr. Gunther van Loon, DVM, PhD, Ass Member ECVDI, Dip ECEIM Dept. of Large Animal Internal Medicine Ghent University, Belgium Murmurs
More informationCase # 1. Page: 8. DUKE: Adams
Case # 1 Page: 8 1. The cardiac output in this patient is reduced because of: O a) tamponade physiology O b) restrictive physiology O c) coronary artery disease O d) left bundle branch block Page: 8 1.
More informationCARDIAC EXAMINATION MINI-QUIZ
CARDIAC EXAMINATION MINI-QUIZ 1. Sitting bolt upright, your dyspneic (short of breath) patient has visible jugular venous pulsations to the angle of his jaw, which is 12 cm above his sternal angle. What
More informationA Case Of Marfan Syndrome With Ascending And Arch Of Aorta Aneurysm Presenting With Type A- Dissection Of Aorta.
A Case Of Marfan Syndrome With Ascending And Arch Of Aorta Aneurysm Presenting With Type A- Dissection Of Aorta. Dr E Srikanth, Dr Ravi Srinivas MD.DM, Dr O Adikesava Naidu MD.DM, FACC,FESC. Dr Y V Subba
More informationCardiac Ausculation in the Elderly
Cardiac Ausculation in the Elderly 박성하 신촌세브란스병원심장혈관병원심장내과 Anatomy Surface projection of the Heart and Great Vessels Evaluating pulsation Superior vena cava Rt. pulmonary artery Right atrium Right ventricle
More informationHeart Valve disease: MR. AS tough patient When to echo, When to refer, What s new
Heart Valve disease: MR. AS tough patient When to echo, When to refer, What s new B. Sonnenberg UAH Cardiology CME Day 5 May 2015 Disclosures Speaker s or Advisory Boards: none Research grants: none (co-investigator
More information2) VSD & PDA - Dr. Aso
2) VSD & PDA - Dr. Aso Ventricular Septal Defect (VSD) Most common cardiac malformation 25-30 % Types of VSD: According to position perimembranous, inlet, muscular. According to size small, medium, large.
More informationMarfan's Syndrome : Natural History and Long-Term Follow-Up of Cardiovascular Involvement
4 JACC Vol. 14, No. August 1989 :4-8 Marfan's Syndrome : Natural History and Long-Term Follow-Up of Cardiovascular Involvement DOMINIC L. MARSALESE, MD, DOUGLAS S. MOODIE, MD, FACC, MICHAEL VACANTE, DO,
More informationEchocardiography as a diagnostic and management tool in medical emergencies
Echocardiography as a diagnostic and management tool in medical emergencies Frank van der Heusen MD Department of Anesthesia and perioperative Care UCSF Medical Center Objective of this presentation Indications
More informationTwo semilunar valves. Two atrioventricular valves. Valves of the heart. Left atrioventricular or bicuspid valve Mitral valve
The Heart 3 Valves of the heart Two atrioventricular valves Two semilunar valves Right atrioventricular or tricuspid valve Left atrioventricular or bicuspid valve Mitral valve Aortic valve Pulmonary valve
More informationPre-participation Screening for the Prevention of sudden Cardiac Death in Young Athletes. Thomas W. Allen, DO, MPH
Pre-participation Screening for the Prevention of sudden Cardiac Death in Young Athletes Thomas W. Allen, DO, MPH Cardiovascular disorders are the leading cause of sudden death in young athletes accounting
More informationOutcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease
Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease TIRONE E. DAVID, MD ; SEMIN THORAC CARDIOVASC SURG 19:116-120c 2007 ELSEVIER INC. PRESENTED BY INTERN 許士盟 Mitral valve
More informationCardiac Cycle MCQ. Professor of Cardiovascular Physiology. Cairo University 2007
Cardiac Cycle MCQ Abdel Moniem Ibrahim Ahmed, MD Professor of Cardiovascular Physiology Cairo University 2007 1- Regarding the length of systole and diastole: a- At heart rate 75 b/min, the duration of
More informationDegenerative Mitral Regurgitation: Etiology and Natural History of Disease and Triggers for Intervention
Degenerative Mitral Regurgitation: Etiology and Natural History of Disease and Triggers for Intervention John N. Hamaty D.O. FACC, FACOI November 17 th 2017 I have no financial disclosures Primary Mitral
More informationValvular Heart Disease Mitral Stenosis
Valvular Heart Disease Mitral Stenosis A 75 year old woman with loud first heart sound and mid-diastolic murmur Chronic dyspnea Class 2/4 Fatigue Recent orthopnea/pnd Nocturnal palpitation Pedal edema
More informationANEURYSM OF THE ASCENDING AORTA SIMULATING RIGHT ATRIAL DILATATION*
OCTOBER, 1969 ANEURYSM OF THE ASCENDING AORTA SIMULATING RIGHT ATRIAL DILATATION* \ ATE HAVE recently encountered I, V patients with cardiomegaly in whom the frontal, lateral and oblique roentgenograms
More informationCase report. Open Access. Abstract
Open Access Case report Late diagnosis of Marfan syndrome with fatal outcome in a young male patient: a case report Aurora Bakalli 1 *, Tefik Bekteshi 1, Merita Basha 2, Afrim Gashi 3, Afërdita Bakalli
More informationDo Now. Get out work from last class to be checked
Do Now Get out work from last class to be checked Heart Actions Cardiac Cycle: One complete heartbeat. The contraction of a heart chamber is called systole and the relaxation of a chamber is called diastole.
More informationHISTORY. Question: What category of heart disease is suggested by the fact that a murmur was heard at birth?
HISTORY 23-year-old man. CHIEF COMPLAINT: Decreasing exercise tolerance of several years duration. PRESENT ILLNESS: The patient is the product of an uncomplicated term pregnancy. A heart murmur was discovered
More informationCardiac Examination. Pediatrics Clinical Examination
Pediatrics Clinical Examination Symptoms of Cardiovascular Affection: Cardiac Examination 1. Perinatal history: Maternal DM, cyanosis, respiratory distress 2. Symptoms of lung congestion: Poor interrupted
More information1. how a careful cardiovascular evaluation can accurately assess pathology and physiology at the bedside, and
This program will demonstrate: 1. how a careful cardiovascular evaluation can accurately assess pathology and physiology at the bedside, and 2. the importance of integrating this information with selected
More informationOUTPUT IN CONGESTIVE HEART FAILURE
TRICUSPID INCOMPETENCE AND RIGHT VENTRICULAR OUTPUT IN CONGESTIVE HEART FAILURE BY PAUL KORNER* AND JOHN SHILLINGFORDt From the Department of Medicine, Postgraduate Medical School, Hammersmith Received
More informationمارفان متلازمة = syndrome Marfan Friday, 15 October :19 - Last Updated Thursday, 11 November :07
1 / 8 MARFAN SYNDROME Epidemiology Marfan syndrome is a generalized connective tissue disease affecting approximately 1 in 5000 to 10,000 individuals, with no racial, gender, or geographic predilection.
More informationEchocardiography in Adult Congenital Heart Disease
Echocardiography in Adult Congenital Heart Disease Michael Vogel Kinderherz-Praxis München CHD missed in childhood Subsequent lesions after repaired CHD Follow-up of cyanotic heart disease CHD missed in
More informationDISCLOSURE. Echocardiography in Systemic Diseases: Questions. Relevant Financial Relationship(s) None. Off Label Usage None 5/7/2018
Echocardiography in Systemic Diseases: Questions Sunil Mankad, MD, FACC, FCCP, FASE Associate Professor of Medicine Mayo Clinic College of Medicine Director, Transesophageal Echocardiography Associate
More informationEvidence for a Mitral Valve Origin of the Left Ventricular Third Heart Sound
Brit. Heart J., 1969, 31, 192. Evidence for a Mitral Valve Origin of the Left Ventricular Third Heart Sound JAMES S. FLEMING From the Cardiac Department, St. Bartholomew's Hospital, London E.C.1 A low
More informationMarfan syndrome: Report of two cases with review of literature
Case Report Marfan syndrome: Report of two cases with review of literature AK Randhawa, C Mishra 1, SB Gogineni 2, S Shetty 2 Departments of Oral Medicine and Radiology, Luxmi Bai Institute of Dental Sciences
More informationSaluki heart pathology study
Heart conditions by MaryDee Sist, DVM Originally published in Baraka Book, Autumn-Winter 2001 For the last decade I have been involved in Saluki heart research. Ouroriginalgoalwastoexaminethe incidence
More informationMITRAL VALVE PROLAPSE IN
181 MITRAL VALVE PROLAPSE IN THE ELDERLY* MAXWELL L. GELFAND, M.D. New York University Medical Center New York, New York M ITRAL valve prolapse, a frequent cause of valvular disease, is known by many other
More informationCardiac Radiography. Jared D. Christensen, M.D.
Cardiac Radiography Jared D. Christensen, M.D. Cardiac radiography Jared D. Christensen, M.D. Overview Basic Concepts Technique Normal anatomy Cases Technique 3 Standard Views Posterior-Anterior (PA) Anterior-Posterior
More information2. The heart sounds are produced by a summed series of mechanical events, as follows:
Heart Sounds. Phonocardiography 1 Objectives 1. Phonocardiography - Definition 2. What produces the heart sounds 3. Where to listen for the heart sounds 4. How to record a phonocardiogram 5. Normal heart
More informationSyncope Due to Intracavitary Left Ventricular Obstruction Secondary to Giant Esophageal Hiatus Hernia
American Journal of Medical Case Reports, 2017, Vol. 5, No. 4, 89-93 Available online at http://pubs.sciepub.com/ajmcr/5/4/4 Science and Education Publishing DOI:10.12691/ajmcr-5-4-4 Syncope Due to Intracavitary
More information8/31/2016. Mitraclip in Matthew Johnson, MD
Mitraclip in 2016 Matthew Johnson, MD 1 Abnormal Valve Function Valve Stenosis Obstruction to valve flow during that phase of the cardiac cycle when the valve is normally open. Hemodynamic hallmark - pressure
More informationUnusual Causes of Aortic Regurgitation. Case 1
Unusual Causes of Aortic Regurgitation Judy Hung, MD Cardiology Division Massachusetts General Hospital Boston, MA No Disclosures Case 1 54 year old female with h/o cerebral aneurysm and vascular malformation
More informationIndex of subjects. effect on ventricular tachycardia 30 treatment with 101, 116 boosterpump 80 Brockenbrough phenomenon 55, 125
145 Index of subjects A accessory pathways 3 amiodarone 4, 5, 6, 23, 30, 97, 102 angina pectoris 4, 24, 1l0, 137, 139, 140 angulation, of cavity 73, 74 aorta aortic flow velocity 2 aortic insufficiency
More informationSee below for descriptions of the waveform
The internal jugular vein (IJV) connects to the right atrium without any intervening valves. The pulsation of the right atrium therefore causes the column of blood in the IJV to rise and fall this is called
More informationThe Heart and Cardiovascular System
The Heart and Cardiovascular System What you will learn The location of the heart 3 layers and covering of the heart Explain the function of the heart as 2 separate pumps Identify the 4 chambers of the
More informationPregnancy, Heart Disease and Imaging. Hemodynamics. Decreased systemic vascular resistance. Physiology anemia
Pregnancy, Heart Disease and Imaging Sangeeta Shah, MD, FASE, FACC Associate Professor, Ochsner Clinical School of Medicine Advanced CV Imaging and Adult Congenital Heart Disease New Orleans, LA Hemodynamics
More informationI (312) Mitral Regurgitation What Should You Know?
Mitral Regurgitation What Should You Know? Table of Contents What is Mitral Regurgitation? 3 What are the Symptoms? 4 What are the risks? 5 Who Gets Mitral Regurgitation? 6 Diagnosing Mitral Regurgitation
More informationCor pulmonale. Dr hamid reza javadi
1 Cor pulmonale Dr hamid reza javadi 2 Definition Cor pulmonale ;pulmonary heart disease; is defined as dilation and hypertrophy of the right ventricle (RV) in response to diseases of the pulmonary vasculature
More informationThe Heart and Heart Disease
The Heart and Heart Disease Illustration of the heart by Leonardo DaVinci heart-surgeon.com/ history.html 2/14/2010 1 I. Location, Size and Position of the Heart A. Triangular organ located 1. of mass
More informationTHE HEART. A. The Pericardium - a double sac of serous membrane surrounding the heart
THE HEART I. Size and Location: A. Fist-size weighing less than a pound (250 to 350 grams). B. Located in the mediastinum between the 2 nd rib and the 5 th intercostal space. 1. Tipped to the left, resting
More informationMurmur Sounds made by turbulence in the heart or blood stream. 1. Timing. 5. Intensity 2. Shape. 6. Pitch 3. Location of maximum intensity
Definition Items in description of Timing Shape Location of maximum intensity Murmur Sounds made by turbulence in the heart or blood stream. 1. Timing 5. Intensity 2. Shape 6. Pitch 3. Location of maximum
More informationHeart sounds and murmurs. Dr. Szathmári Miklós Semmelweis University First Department of Medicine 15. Oct
Heart sounds and murmurs Dr. Szathmári Miklós Semmelweis University First Department of Medicine 15. Oct. 2013. Conditions for auscultation of the heart Quiet room Patient comfortable Chest fully exposed
More informationUptofate Study Summary
CONGENITAL HEART DISEASE Uptofate Study Summary Acyanotic Atrial septal defect Ventricular septal defect Patent foramen ovale Patent ductus arteriosus Aortic coartation Pulmonary stenosis Cyanotic Tetralogy
More informationWithout echocardiography is
Diagnosis of valvular heart disease Without echocardiography is like traveling on a horseback or at best on a steam train 1 Echocardiography 2D 2 Diagnosis of valvular heart desease Aortic valve disease
More information(i) Family 1. The male proband (1.III-1) from European descent was referred at
1 Supplementary Note Clinical descriptions of families (i) Family 1. The male proband (1.III-1) from European descent was referred at age 14 because of scoliosis. He had normal development. Physical evaluation
More informationAnatomy & Physiology
1 Anatomy & Physiology Heart is divided into four chambers, two atrias & two ventricles. Atrioventricular valves (tricuspid & mitral) separate the atria from ventricles. they open & close to control flow
More informationThe Cardiovascular System Part I: Heart Outline of class lecture After studying part I of this chapter you should be able to:
The Cardiovascular System Part I: Heart Outline of class lecture After studying part I of this chapter you should be able to: 1. Describe the functions of the heart 2. Describe the location of the heart,
More informationWhich one of the following echocardiographic profiles most strongly indicates the need for aortic valve replacement? FS [
Question 46 A 45-year-old asymptomatic man returns for follow-up. He was diagnosed 10 years ago with aortic regurgitation due to a congentia lbicuspid aortic valve, He has never had endocarditis Which
More informationIB TOPIC 6.2 THE BLOOD SYSTEM
IB TOPIC 6.2 THE BLOOD SYSTEM THE BLOOD SYSTEM TERMS TO KNOW circulation ventricle artery vein 6.2.U1 - Arteries convey blood at high pressure from the ventricles to the tissues of the body Circulation
More informationMitral Valve Disease. Chapter 29
Chapter 29 Mitral Valve Disease Thomas R. Griggs Mitral valve leaflets consist of thin, pliable, fibrous material. The two leaflets anterior and posterior open by unfolding against the ventricular wall
More informationIB TOPIC 6.2 THE BLOOD SYSTEM
IB TOPIC 6.2 THE BLOOD SYSTEM TERMS TO KNOW circulation ventricle artery vein THE BLOOD SYSTEM 6.2.U1 - Arteries convey blood at high pressure from the ventricles to the tissues of the body Circulation
More informationMARFANS SYNDROME-A CASE REPORT
TJPRC:International Journal of Cardiology, Echocardiography & Cardiovascular Medicine (TJPRC:IJCECM) Vol. 1, Issue 1 Jun 2015 1-6 TJPRC Pvt. Ltd. MARFANS SYNDROME-A CASE REPORT MEENA, PRAVEENA, PRIYA &
More informationPathophysiology: Left To Right Shunts
Pathophysiology: Left To Right Shunts Daphne T. Hsu, MD dh17@columbia.edu Learning Objectives Learn the relationships between pressure, blood flow, and resistance Review the transition from fetal to mature
More informationCardiology/Cardiothoracic
Cardiology/Cardiothoracic ICD-9-CM to ICD-10-CM Code Mapper 800-334-5724 www.contexomedia.com 2013 ICD-9-CM 272.0 Pure hypercholesterolemia 272.2 Mixed hyperlipidemia 272.4 Other and hyperlipidemia 278.00
More informationPART II ECHOCARDIOGRAPHY LABORATORY OPERATIONS ADULT TRANSTHORACIC ECHOCARDIOGRAPHY TESTING
PART II ECHOCARDIOGRAPHY LABORATORY OPERATIONS ADULT TRANSTHORACIC ECHOCARDIOGRAPHY TESTING STANDARD - Primary Instrumentation 1.1 Cardiac Ultrasound Systems SECTION 1 Instrumentation Ultrasound instruments
More informationSports Participation in Patients with Inherited Diseases of the Aorta
Sports Participation in Patients with Inherited Diseases of the Aorta Yonatan Buber, MD Adult Congenital Heart Service Leviev Heart Center Safra Childrens Hospital Disclosures None Patient Presentation
More informationCongenital heart disease. By Dr Saima Ali Professor of pediatrics
Congenital heart disease By Dr Saima Ali Professor of pediatrics What is the most striking clinical finding in this child? Learning objectives By the end of this lecture, final year student should be able
More informationSymptomatic mitral myxomatous
Symptomatic mitral myxomatous transformation in the elderly P. COLLINS, R. E. COTTON, and R. S. DUFF Departments of Cardiology and Pathology, City Hospital, Nottingham Thorax (1976), 31, 765. Collns, P.,
More informationCURRENT SURVEY MAX ZOOB. M.D., M.R.C.P. Consultant Cardiologist, Regional Cardiac Unit, Brook Hospital, London, S.E. 18
Postgrad. med. J. (March 1969) 45, 180-185. CURRENT SURVEY Non-rheumatic mitral incompetence and papillary muscle dysfunction Summary Non-rheumatic mitral incompetence may be caused by a variety of conditions
More informationECHOCARDIOGRAPHIC APPROACH TO CONGENITAL HEART DISEASE: THE UNOPERATED ADULT
ECHOCARDIOGRAPHIC APPROACH TO CONGENITAL HEART DISEASE: THE UNOPERATED ADULT Karen Stout, MD, FACC Divisions of Cardiology University of Washington Medical Center Seattle Children s Hospital NO DISCLOSURES
More informationAdult Echocardiography Examination Content Outline
Adult Echocardiography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 4 5 Anatomy and Physiology Pathology Clinical Care and Safety Measurement Techniques, Maneuvers,
More informationDOWNLOAD PDF CH. 13. MITRAL REGURGITATION
Chapter 1 : Mitral Regurgitation Mitral valve regurgitation â also called mitral regurgitation, mitral insufficiency or mitral incompetence â is a condition in which your heart's mitral valve doesn't close
More informationImages in Cardiovascular Medicine
Images in Cardiovascular Medicine Management of Severe Mitral Stenosis During Pregnancy Rebecca S. Norrad, MBBS; Omid Salehian, MSc, MD, FRCPC, FACC, FAHA A 37-year-old woman originally from Iraq was referred
More informationAcute aortic dissection and medial degeneration
T7horax (1976), 31, 49. Acute aortic dissection and medial degeneration in patients with 'floppy' mitral valves ROXANE McKAY and MAGDI H. YACOUB The Cardiothoracic Surgical Unit, Harefield Hospital, Middlesex
More informationAbstract Clinical and paraclinical studies on myocardial and endocardial diseases in dog
Abstract The doctoral thesis entitled Clinical and paraclinical studies on myocardial and endocardial diseases in dog was motivated by the study of the most frequent cardiopathies in dogs, which involves
More informationTest Review Circulatory System Chapters
Test Review Circulatory System Chapters 13-2010 1. The tissue that forms the tight fitting sac around the heart is the a. parietal pericardium c. myocardium b. visceral pericardium d. endocardium 2. Which
More informationPRELIMINARY STUDIES OF LEFT VENTRICULAR WALL THICKNESS AND MASS OF NORMOTENSIVE AND HYPERTENSIVE SUBJECTS USING M-MODE ECHOCARDIOGRAPHY
Malaysian Journal of Medical Sciences, Vol. 9, No. 1, January 22 (28-33) ORIGINAL ARTICLE PRELIMINARY STUDIES OF LEFT VENTRICULAR WALL THICKNESS AND MASS OF NORMOTENSIVE AND HYPERTENSIVE SUBJECTS USING
More informationThe Heart. Size, Form, and Location of the Heart. 1. Blunt, rounded point; most inferior part of the heart.
12 The Heart FOCUS: The heart is composed of cardiac muscle cells, which are elongated, branching cells that appear striated. Cardiac muscle cells behave as a single electrical unit, and the highly coordinated
More informationCommon Codes for ICD-10
Common Codes for ICD-10 Specialty: Cardiology *Always utilize more specific codes first. ABNORMALITIES OF HEART RHYTHM ICD-9-CM Codes: 427.81, 427.89, 785.0, 785.1, 785.3 R00.0 Tachycardia, unspecified
More informationMATRIX VHD FORM. State the name of the patient ( Product Recipient ) for whom you are providing the information contained in this form.
MATRIX VHD FORM A. Patient Information State the name of the patient ( Product Recipient ) for whom you are providing the information contained in this form. (First Name) (Middle Initial) (Last Name) (Date
More informationValve Disease Board Review Questions
Valve Disease Board Review Questions Dennis A. Tighe, MD, FASE University of Massachusetts Medical School Worcester, MA Case 1 History A 61 year-old man Presents to hospital with worsening shortness of
More information'circular shunt'1. CASE 1 Shortly after birth a 36-hour-old, full-term infant girl showed cyanosis and dyspnoea. Physical
Pulmonary atresia with left ventricularright atrial communication: basis for 'circular shunt'1 Thorax (1966), 21, 83. KENNETH L. JUE, GEORGE NOREN, AND JESSE E. EDWARDS From the Departments of Paediatrics
More informationThe Cardiac Cycle Clive M. Baumgarten, Ph.D.
The Cardiac Cycle Clive M. Baumgarten, Ph.D. OBJECTIVES: 1. Describe periods comprising cardiac cycle and events within each period 2. Describe the temporal relationships between pressure, blood flow,
More informationA growth disturbance and not a disorder with ligamentous laxity
Marfan Syndrome A growth disturbance and not a disorder with ligamentous laxity 1 in 5,000-10,000 extensive phenotypic variability Fibrillin-1 abnormality Chromsome no. 15 Different forms of mutations
More informationThe Bicuspid Aortic Valve: New Frontiers in Genetics and Interventions
The Bicuspid Aortic Valve: New Frontiers in Genetics and Interventions Westfälische Wilhelms-Universität Münster Helmut Baumgartner Adult Congenital and Valvular Heart Disease Center Dept. of Cardiology
More informationSAMPLE HLTEN610A. TAFE NSW Training and Education Support Industry Skills Unit, Meadowbank. Practise in the cardiovascular nursing environment
TAFE NSW Training and Education Support Industry Skills Unit, Meadowbank HLTEN610A Practise in the cardiovascular nursing environment Version 1.0 Flexible Learner Resource Product Code: ISO 9001 HLTEN610A
More informationIntravenous Digital Subtraction Aortography in the Preoperative and Postoperative Evaluation of Marfan's Aortic Disease*
Intravenous Digital Subtraction Aortography in the Preoperative and Postoperative Evaluation of Marfan's Aortic Disease* Robert Detrano, M.D., Ph.D.; DouglasS. Moodie, M.D., F.C.C.P.; Carl C. Gill, M.D.,
More information