BACKGROUND AND OBJECTIVES: Stress induced cardiomyopathy has been reported as reversible left ventricular dysfunction with electrocardiographic changes. Although the exact mechanism of this dysfunction has not been clarified, catecholamine "surge" is suspected as a potential cause of this disease. It has not been undergone the studies about the effect of chronic or recurrent psychological stress on the myocardium. We suspect that reversible ischemic change of myocardium could be induced by chronic or recurrent emotional stress. MATERIALS AND METHOD: The clinical, echocardiographic and angiographic data of 189 patients (72 women) who presented with ischemic symptoms and eletrocardiographic changes were participated. BAI (Beck anxiety inventory) and BDI (Beck Depression inventory) were obtained and analyzed for evaluation of degree of psychological stress. RESULTS: 54 patients who had left ventricular apical wall motion abnormalities without significant angiographical stenosis in the coronary artery were younger than the others with left ventricular wall motion abnormalities and angiographic stenosis. And they increased the BAI and BDI as tools of evaluation of psychological stress (p<0.05). CONCLUSION: Data of this study suggested that psychological stress can be associated with myocardial dysfunction. It can be postulated that psychological stress should be considered as one of the cause of non-coronary myocardial injury.
Anxiety ; Cardiomyopathies ; Constriction, Pathologic ; Coronary Vessels ; Depression ; Echocardiography ; Electrocardiography ; Heart Ventricles* ; Humans ; Myocardium ; Stress, Psychological ; Ventricular Dysfunction, Left

OBJECTS: Atherosclerosis is closely related with the coronary artery disease, cerebrovascular disease, and peripheral arterial disease. Recently, It was revealed that a common cause of death in Korea is cardiovascular disease, like a western country. So the early detection of atherosclerosis and prevention of atherosclerosis is very important aspect. There are several methods to evaluate the early atherosclerosis. Among them, flow mediated vasodilation of brachial artery and intima-media thickness of carotid artery are commonly used surrogate marker of early atherosclesrosis. The aim of this article is to review published papers how we can apply these methods to assess the early atherosclerosis. METHOD AND RESULT: In medline search, seventy four articles were selected to review the method and clinical application of these two methods. Most of these papers were from peer reviewed journals. CONCLUSION: Flow-mediated vasodilation and the measurement of intima-media thickness of carotid artery were very useful and important methods to detect early atherosclerosis. and also to evaluate the clinical efficacy of various kinds of intervention to assess the vascular function and structure.
Atherosclerosis* ; Biomarkers ; Brachial Artery ; Cardiovascular Diseases ; Carotid Arteries ; Cause of Death ; Coronary Artery Disease ; Korea ; Peer Review ; Peripheral Arterial Disease ; Ultrasonography* ; Vasodilation

The cardiomyopathies constitute a group of diseases in which the dominant feature is direct involvement of the heart muscle itself. They are distinctive because they are not the result of pericardial, hypertensive, congenital, valvular, or ischemic diseases. Although the diagnosis of cardiomyopathy requires the exclusion of these etiological factors, the features of cardiomyopathy are often sufficiently distinctive-both clinically and hemodynamically-to allow a definitive diagnosis to be made. With increasing awareness of this condition, along with improvements in diagnostic techniques, cardiomyopathy is being recognized as a significant cause of morbidity and mortality. Whether the result of improved recognition or of other factors, the incidence and prevalence of cardiomyopathy appear to be increasing. A variety of schemes have been proposed for classifying the cardiomyopathies. The most widely recognized classification is that promulgated jointly by the World Health Organization (WHO) and the International Society and Federation of Cardiology (ISFC). In the WHO/ISFC classification, the cardiomyopathies are classified based on their predominant pathophysiological features; other diseases that affect the myocardium that are associated with a specific cardiac disorder or are part of a generalized systemic disorder are termed specific cardiomyopathies. Three basic types of functional impairment have been described: 1) dilated (DCM, formerly called congestive), the most common form, accounting for 60 percent of all cardiomyopathies and characterized by ventricular dilatation, contractile dysfunction, and often symptoms of congestive heart failure; 2) hypertrophic (HCM), recognized by inappropriate left ventricular hypertrophy, often with asymmetrical involvement of the interventricular septum, with preserved or enhanced contractile function until late in the course; and 3) restrictive (RCM), the least common form in western countries, marked by impaired diastolic filling and in some cases with endocardial scarring of the ventricle. Two other forms of cardiomyopathy are recognized: arrhythmogenic right ventricular cardiomyopathy and unclassified; the latter includes fibroelastosis, systolic dysfunction with minimal dilatation, and mitochondrial involvement. The distinction between the three major functional categories is not absolute, and often there is overlap; in particular, patients with HCM also have increased wall stiffness as a consequence of the myocardial hypertrophy and thus present some of the features of an RCM. Late in their course, ventricular dilation and systolic heart failure, bearing some resemblance to DCM, may occur. The aim of this review is to introduce the unusual forms of cardiomyopathy with the current literatures in this field.
Arrhythmogenic Right Ventricular Dysplasia ; Cardiology ; Cardiomyopathies* ; Cicatrix ; Classification ; Diagnosis ; Dilatation ; Heart Failure ; Heart Failure, Systolic ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Incidence ; Mortality ; Myocardium ; Prevalence ; World Health Organization

Rupture of the interventricular septum is a serious complication of acute myocardial infarction, accounting for 5% of death due to acute myocardial infarction. The mortality with medical therapy alone exceeds 90%. Accurate diagnosis, urgent management, and early operative correction are necessary for survival. We report cases of 3 patients with ventricular septal rupture after acute myocardial infarction.
Diagnosis ; Humans ; Mortality ; Myocardial Infarction* ; Rupture ; Ventricular Septal Rupture*

Double-chambered right ventricle (DCRV) is a congenital cardiac anomaly in which the right ventricle is divided into two chambers by anomalous hypertrophied muscle bundles that cross the right ventricular cavity. DCRV may be associated with other congenital cardiac anomalies, most commonly with ventricular septal defect. We report two cases of DCRV without other congenital cardiac anomalies with review of literatures. We performed echocardiography, cardiac catheterization and right ventricular angiogram to confirm the diagnosis.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography ; Heart Septal Defects, Ventricular ; Heart Ventricles*

Myocardial calcification is usually classified as either dystrophic or metastatic. Dystrophic calcification is more common and usually occurs in the area of prior myocardial infarction. It is found in 8% of patients who have been survived longer than 6 years after myocardial infarction. The most common site of calcification is in the anterior wall of the left ventricle or apical and anterolateral aspect in the aneurysm of the left ventricle. We report the case of a 50-years old man with a typical dystrophic calcification of the endocardium in area of myocardial necrosis.
Aneurysm ; Calcinosis ; Echocardiography ; Endocardium ; Heart Ventricles ; Humans ; Middle Aged ; Myocardial Infarction* ; Necrosis

Intravenous leiomyomatosis is an uncommon benign tumor arising from either the uterine venous wall or uterine leiomyoma. Although this tumor is usually confined to the pelvic cavity, sometimes it can extend into the cardiac cavity and brings on sudden death. We report a case of intravenous leiomyomatosis extending into the right atrium, right ventricle and both pulmonary arteries by seeding. The tumor was detected with transthoracic echocardiography and appropriately diagnosed by transesophageal echocardiography and cardiac MRI. Entire tumor was successfully removed by one-stage radical surgery under cardiopulmonary bypass.
Cardiopulmonary Bypass ; Death, Sudden ; Echocardiography ; Echocardiography, Transesophageal ; Heart Atria* ; Heart Ventricles* ; Leiomyoma ; Leiomyomatosis* ; Magnetic Resonance Imaging ; Pulmonary Artery*

Fibrosing mediastinitis is a rare benign disorder caused by excessive proliferation of fibrous tissue within the mediastinum. Pulmonary artery stenosis is uncommon complication of fibrosing mediastinitis. We present a case of percutaneous stent deployment in a patient with severe pulmonary artery stenosis causing pulmonary hypertension secondary to fibrosing mediastinitis.
Constriction, Pathologic ; Humans ; Hypertension, Pulmonary* ; Mediastinitis* ; Mediastinum ; Pulmonary Artery* ; Stents*

BACKGROUND: Recognition of ischemic right ventricular (RV) dysfunction in the course of inferior wall left ventricular (LV) acute myocardial infarction is important in clinical practice. The Doppler Tei index is useful for estimating global cardiac function. However, the clinical usefulness of RV Tei index to diagnose subclinical RV dysfunction has not been investigated. The purpose of this study was to assess the clinical value of RV Tei index for diagnosis of subclinical RV dysfunction associated with inferior wall acute myocardial infarction who did not have definite ECG changes at right precordial leads. METHODS: The study population consisted of 22 consecutive patients (male 10, average age 57+/-12) with acute inferior myocardial infarction who did not have specific ST segment changes at right precordial leads. RV Tei index was measured by Doppler echocardiography and RV ejection fraction (EF) was measured by multigated blood pool (MUGA) SPECT. We defined subclinical RV dysfuntion as estimated RA pressure was > or =10 mmHg (group 1) by right heart catheterization. RESULTS: In patients with RV dysfunction, RV Tei index was significantly increased compared with those who did not have RV dysfunction (0.51+/-0.22 vs 0.35+/-0.18, p<0.05). RVEF by MUGA blood pool SPECT was significantly decreased in patients with RV dysfunction (35+/-11% vs 47+/-12, p<0.05). CONCLUSION: RV Tei index is simple and useful non-invasive method for diagnosis of subclinical RV dysfunction associated with inferior wall acute myocardial infarction who did not have typical ECG changes at right precordial leads.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography, Doppler ; Electrocardiography ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Tomography, Emission-Computed, Single-Photon ; Ventricular Dysfunction, Right*

BACKGROUND: Aging is an important factor to determine transmitral inflow velocity pattern. Cardiac geometry such as left ventricular (LV) volume, mass and left ventricular outflow tract (LVOT) was also changed with age. The aim of this study was to assess the impact of geometric change of LVOT on transmitral inflow velocity pattern excluding a factor of age. METHODS: Healthy 115 (61 men, 37+/-15 years) individuals were enrolled. Echocardiography was performed to measure LV mass, thickness, left atrial (LA) size, aortoseptal angle (ASA), early (E) and late (A) transmitral inflow velocity, and deceleration time (DT). ASA was measured at mid-diastole in apical long-axis view according to a method as the open angle between the edge of the interventricular septum and axis perpendicular to the aortic annulus. The relation between transmitral inflow velocity pattern and LV geometric parameters was analyzed by regression analysis. RESULTS: Simple regression analysis demonstrated a significant correlation between transmitral inflow parameters with age and geometric parameters (ASA, LA size and LV mass index). Multiple regression analysis, taking into consideration age, ASA, LA size and LV mass index showed that only age was an independent predictor for E, A, DT, and E/A ratio (r2=0.210, Beta coefficient (beta)=0.459, p<0.001;r2=0.427, beta=0.654, p<0.001;r2=0.227, beta=-0.476, p<0.001;r2=0.436, beta=-0.661, p<0.001, respectively). But, excluding age, ASA was an independent predictor for E, A, DT, and E/A ratio (r2=0.151, beta=0.389, p<0.001;r2=0.294, beta=0.542, p<0.001;r2=0.227, beta=-0.476, p<0.001;r2=0.260, beta=0.509, p<0.001, respectively). CONCLUSION: ASA, a parameter of LVOT geometry, might be an important factor related to transmitral inflow velocity pattern excluding a factor of age.
Aging ; Axis, Cervical Vertebra ; Deceleration ; Diastole ; Echocardiography ; Heart Ventricles ; Humans ; Male