A left atrial aneurysm is a very rare cardiac anomaly that usually develops in the left atrial appendage. It usually develops congenitally, and has a risk of life-threatening complications. Here, we report a case of a growing aneurysm of the left atrium that was incidentally found in a 42-yr-old woman. Eighteen years prior, an abnormal cardiomegaly was found on a chest radiography for a pre-operative study. The chest radiography at this time demonstrated a more prominent cardiomegaly than the previous radiography findings. The left atrial aneurysm was diagnosed by echocardiography and cardiac catheterization. Although asymptomatic, she underwent a successful surgical excision to allay the possibilities of rupture, arrhythmia, heart failure, or thromboembolism. The surgical findings demonstrated an 8 x 15 cm sized saccular aneurysm at the left atrial appendage, and the pathologic findings showed three myocardial layers. The patient has been asymptomatic during the 15 months of follow-up. In conclusion, a congenital left atrial aneurysm can grow with time, even in asymptomatic cases, and an aneurysmectomy is a curative treatment, which can eliminate the potential complications.
Adult ; Echocardiography ; Female ; Heart Aneurysm/congenital* ; Heart Aneurysm/pathology* ; Heart Aneurysm/surgery ; Heart Aneurysm/ultrasonography ; Heart Atria/pathology* ; Heart Atria/surgery ; Heart Atria/ultrasonography ; Human

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

The authors have studied the findings of radionuclear scanning, inferior vena cavography and ultrasonographyin 2 cases of Budd-chiari Sundrome experienced diffuse inhomogeneous uptake throughout enlarged liver without colddefects. Slightly increased activity in the central portion of liver in case I and markedly increased activity inthe caudate lobe in case II were observed. In inferior vena cavography, the dilated hepatic veins formingintrahepatic collaterals were seen in enlarged caudate lobe. Marked stenosis of I.V.C. at the level of confluenceto right atrium, intraluminal thrombosis of I.V.C., partial obstruction of hepatic veins by thrombi at theconfluent portion and systemic collaterals were noted in case I. In case II, abrupt conical obstruction of I.V.C.at the orgin of hepatic segment, which is consistent with membrane or web. was seen. Prominent systemiccollaterals were developed through the serpinginous margedly dilated azygos and hemiazygos veins, and splenorenalshunt. In ultrasonography, diffuse narrowing and obstruction of hepatic veins at eh confluent level by echogenicnodules were seen in 2 cases. Prominent intrahepatic venous collaterals were observed in case II.
Budd-Chiari Syndrome ; Constriction, Pathologic ; Heart Atria ; Hepatic Veins ; Hepatomegaly ; Liver ; Membranes ; Thrombosis ; Ultrasonography ; Veins

Primary cardiac sarcomas are extremely rare. We report a case of a primary cardiac sarcoma with myxoid change, which originally presented as a benign cardiac myxoma on a two- dimensional echocardiogram. On operating, the mass was found to extend into the posterior left atrial wall, the left pulmonary vein, and the mitral valve. The patient underwent wide resection of the left atrium, a mitral valve replacement and a left pneumonectomy. The histological diagnosis was of an undifferentiated primary cardiac sarcoma. The patient had postoperative chemotherapy. The patient expired 11 months after surgery due to a recurrence of the cardiac sarcoma. Although most tumors that develop in the left atrium are benign myxomas, we should make a preoperative differential diagnosis.
Adult ; Diagnosis, Differential ; Female ; Heart Atria ; Heart Neoplasms/*pathology/surgery/ultrasonography ; Human ; Intraoperative Period ; Myxoma/*pathology/ultrasonography ; Sarcoma/*pathology/surgery/ultrasonography

We experienced a case of Ebstein's anomaly prenatally by fetal sonography. Ebstein's anomaly is a rare congenital heart defect characterized by abnormally downward displacement of the septal and posterior leaflets of the tricuspid valve. In the absence of tricuspid regurgitation, this condition may be completely asymptomatic. On the other hand, symptomatic newborns often develop life-threatening congestive heart failure. A 30-year-old multiparous woman was referred for the evaluation of fetal cardiac defect at 26th gestational week from a private clinic. Fetal ultrasonography showed markedly enlarged right atrium and downward displacement of tricuspid valve into the right ventricle. After discussion with the patient, the pregnancy was terminated and Ebstein's anomaly was confirmed by autopsy.
Adult ; Autopsy ; Ebstein Anomaly* ; Female ; Hand ; Heart Atria ; Heart Defects, Congenital ; Heart Failure ; Heart Ventricles ; Humans ; Infant, Newborn ; Pregnancy ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ultrasonography, Prenatal

BACKGROUND: Spontaneous echo contrast (SEC) of the left atrium (LA) is associated with increased risk of thromboembolism in patients with mitral stenosis(MS). The determination of the presence and severity of LA spontaneous echo contrast(SEC) is of prognostic importance in these patients. Harmonic imaging(HI), a novel echocardiographic technique that differs from conventional fundamental imaging(FI) by transmitting ultrasound at one frequency and receiving at twice the transmitted frequency, produces better endocardial border definition and myocardial opacification. However, there are no data about its value on the detection of LA SEC. The purpose of this study was to investigate the utility of transthoracic noncontrast HI in the detection of LA SEC in patients with. METHODS: Seventy-four consecutive patients with MS (49 female, mean age 51) underwent standard transthoracic echocardiograms (TTE) in both HI and FI and transesophageal echocardiography (TEE) to determine the presence and severity of LA SEC. LA SEC was graded by TEE; mild if only seen at high gain, severe if visible in the entire LA at normal gain control of the equipment. Control subjects comprised of 30 patients randomly selected from patients who did not have LA SEC at TEE examination. RESULTS: Atrial fibrillation was found in 46 patients (62.2%). The mean mitral valve area and mean mitral gradient were 1.0+/-0.3cm2 and 8.2+/-4.1mmHg, respectively. Nine patients (12.2%) had episodes of systemic embolism; stroke in 8 and peripheral embolism in 1. LA thrombus was found in 11 patients (14.9%) by TEE. LA SEC was present in all but one patient by TEE (mild in 35, severe in 38 patients). FI of TTE, however, revealed LA SEC in only 5 (6.8%) of the 73 patients. In contrast, in HI, LA SEC could be detected in 63 (86.3%) of the 73 patients. In the detection of severe LA SEC, the sensitivity of FI and HI were 13.2% (5/38) and 100% (38/38), respectively. LA SEC was not observed in control subjects either by FI or HI. CONCLUSION: Transthoracic HI significantly enhances the detection of LA SEC in patients with MS.
Atrial Fibrillation ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Female ; Heart Atria ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Stroke ; Thromboembolism ; Thrombosis ; Ultrasonography

PURPOSE: Tumoral neovascularity characteristic of venous invasion of renal cell carcinoma has been demonstrated using angiography, computed tomography, and color Doppler duplex ultrasonography. Previous reports on the characteristic findings of MR imaging have, however, been sporadic. The purpose of this study was to evaluate the usefulness of a patchy signal seen on MR images within the venous thrombus of renal cell carcinoma as a sign of tumor neovascularity. MATERIALS AND METHODS: Six patients with histopathologically-proven unilateral renal cell carcinoma (right:left=3:3) with venous tumor thrombi were included in this study. MR imaging findings were retrospectively analyzed with respect to the presence of patchy signals within a thrombus in a renal vein, the IVC, or the right atrium. MR imaging findings on spin-echo and gradient-echo images were compared with histopathologic findings especially in terms of tumor neovascularity. RESULTS: On histopathologic examination, a tumor thrombus was found in the renal vein in three patients, in the IVC in six, and within the right atrium in two. Patchy signals were demonstrated on MR images in one of three patients with renal vein invasion, in four of six with IVC invasion, and in both patients with right atrial invasion. CONCLUSION: On MR imaging, a patchy signal within a venous thrombus is a helpful sign suggesting tumor neovascularity, one of the characteristics of venous invasion by renal cell carcinoma.
Angiography ; Carcinoma, Renal Cell* ; Heart Atria ; Humans ; Magnetic Resonance Imaging ; Renal Veins ; Retrospective Studies ; Thrombosis ; Ultrasonography, Doppler, Duplex

OBJECTIVE: To evaluate the application of ultrasonography in prenatal diagnosis of left inferior vena cava and double inferior vena cava in fetus. METHODS: The clinical data and ultrasonographic findings of the fetuses with left inferior vena cava (18 cases) or double inferior vena cava (16 cases) were retrospectively analyzed. RESULTS: The ultrasonographic images of left inferior vena cava showed that in the transverse view of the fetal upper abdomen the inferior vena cava and abdominal aorta were in the normal position; below the level of the hilum, the inferior vena cava was located behind the left side of the abdominal aorta; at the level of the hilum, it crossed the front of the abdominal aorta and run diagonally to the upper right, forming the right inferior vena cava and finally entered into the right atrium. The ultrasonographic images of double inferior vena cava showed that in the transverse view of the fetal lower abdomen, in front of spine there were three transections of blood vessels; in coronal plane of abdomen, the veins run on both sides of the abdominal aorta and entered to the iliac vein of the same side. In 34 cases of abnormal inferior vena cava, there were 17 cases complicated with other system abnormalities, including 13 cases of cardiac anomalies. CONCLUSIONS The left inferior vena cava and double inferior vena cava have characteristic imaging findings, and prenatal diagnosis can be made with ultrasonography. This type of congenital deformity is frequently complicated with other system abnormalities, which should be excluded in fetus, especially for heart system.
Female ; Fetus ; abnormalities ; Heart Atria ; abnormalities ; Humans ; Pregnancy ; Retrospective Studies ; Ultrasonography ; Vena Cava, Inferior ; abnormalities ; diagnostic imaging

The best tip position of PICC is located in the inferior 1/3 of superior vena cava to the junction between superior vena cava and right atrium. Ensuring the best tip position of PICC is very important for the treatment of patients. In this paper, the applications of X-ray positioning, electrocardiograph, ultrasound, electrocardiograph Doppler ultrasound guidance, and electromagnetic navigation system in PICC tip positioning technology are reviewed. The future development of PICC tip positioning technology is prospected.
Catheterization, Central Venous ; Central Venous Catheters ; Electrocardiography ; Heart Atria ; Humans ; Ultrasonography, Doppler ; Vena Cava, Superior ; X-Rays