Six cases with Straight back syndrome were reported and studied by physiological, radiological electrocardiographic, phonocardiographic and echocardiographic evidences. They were classified according to A-P diameter and arch distance as Type I, II, III. by Kim's Consideration. 1. It was noticed that "pancake" configuration of heart with or without LVH in chest PA view with subsequent compression of the heart against the sternum and straight thoracic vertebra in lateral view was revealed. 2. Anterior-posterior diameter, and A-P/T ratio of six patients were below the average value. 3. Grade 2-3/6 ejection type systolic murmurs on pulmonary artery area and lateral sternal border or apex were auscultated, but systolic murmur on apex was considered to be insignificant due to normal mitral valve motion by Echocardiogram. 4. On ECG, there was observed one case with atrial fibrillation and the other with sinus bradycardia who had prominant straight thoracic vertebra. 5. There was observed normal mitrla valve motion on Echocardiogram in all six cases.
Atrial Fibrillation ; Bradycardia ; Echocardiography ; Electrocardiography ; Heart ; Humans ; Mitral Valve ; Pulmonary Artery ; Spine ; Sternum ; Systolic Murmurs ; Thorax

No abstract available.
Heart Murmurs*

We report a case in whom there was right ventricular outflow tract obstruction by extended metastasis from esophageal cancer. A 65-year-old man was admitted to hospital for evaluation of recent onset of weight loss of recent onset and a heart murmur. Physical examination revealed a regular heart rate of 62 beats per minute and a blood pressure of 110/70 mmHg. On cardiac auscultation, a grade 4/6 systolic murmur was heard over the area of pulmonic valve. Electrocardiography showed low voltage. Chest radiography showed a normal cardiac configuration and no pulmonary abnormality was seen. Esophagogram and endoscopy showed a 10cm sized ulcerative and infiltrative esophageal cancer. This esophageal cancer was histologically proven to be a squamous cell carcinoma. To assess the cardiac metastasis, echocardiography, MRI, coronary angiography, and endomyocardial biopsy were performed. The MRI, echocardiography and right ventriculography revealed a 7 cm sized lobulated mass extending to the right ventricular outflow tract, right ventricle, septum, and anterior wall of the left ventricle. Interestingly, the feeding vessels of the tumor were identified by echocardiography and coronary angiography. Histologically, the cardiac tumor was proven to be have the same pathologic findings as the an esophageal cancer, compatible with carcinomatous metastasis.
Aged ; Biopsy ; Blood Pressure ; Carcinoma, Squamous Cell ; Coronary Angiography ; Echocardiography ; Electrocardiography ; Endoscopy ; Esophageal Neoplasms* ; Heart Auscultation ; Heart Murmurs ; Heart Neoplasms ; Heart Rate ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Physical Examination ; Radiography ; Systolic Murmurs ; Thorax ; Ulcer ; Weight Loss

Aneurysm of the pulmonary artery is a rate entity. A neonate was seen with cyanosis and tachypnea. There was a grade 4/6 systolic murmur along the left sternal border. The chest X-ray showed a round mass shadow in the left parahilar region. Echocardiogram showed large Ventricular Septal Defect and mild Pulmonary Stenosis. The cardiac angiogram showed giant aneurysm of pulmonary artery. Surgical intervention was advised. However, the patient was discharged against operative plan. And the patient died two weeks later.
Aneurysm* ; Cyanosis ; Heart Septal Defects, Ventricular* ; Humans ; Infant, Newborn ; Pulmonary Artery ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Tachypnea ; Thorax

An 11-year-old, castrated male dog presented with a 3-month history of cough and depression. Auscultation revealed systolic murmur and thoracic radiographs showing enlargement of both the atrium and left ventricle. Echocardiography showed thickened mitral valve and moderate-to-severe left atrial enlargement. Additionally, M-mode echocardiography showed symmetric left ventricular wall thickening and systolic anterior motion of the mitral valve, while Doppler imaging revealed high velocity turbulent flow through the left ventricular outflow tract. Based on echocardiography, this case was diagnosed with hypertrophic obstructive cardiomyopathy. After 5 months, the dog was clinically static in radiography and echocardiography.
Animals ; Auscultation ; Cardiomyopathy, Hypertrophic ; Child ; Cough ; Depression ; Dogs ; Echocardiography ; Heart Ventricles ; Humans ; Male ; Mitral Valve ; Radiography ; Systolic Murmurs

Heart failure is the most common cause of death of infective endocarditis. The contributing factors of heart failure include valve destruction, myocarditis, coronary artery emboli with myocardial infarction and abscess. Recently, we experienced a thiry nine year-old man who was hospitalized at Inha University Hospital because of fever, chill and dyspnea (NYHA functional class I-II). The grade IV/Vi systolic murmur was heard at the right upper sternal border and the apex and the grade III/VI diastolic murmur was heard at Erb's area. No crackles were heard. Blook cultures grew Streptococcus viridans. Chest X-ray showed mild cardiomegaly without pulmonary congestion sign. Echocardiogram showed aortic valve vegetations, abscess and grade II/IV aortic regurgitation. Aortic valve replacement and abscess removal were performed. Findings included henegg sized abscess which reduced 70% of cross sectional area of left ventricular outflow tract and located between posterior wall of left ventricle and right and left coronary rings.
Abscess ; Aortic Valve ; Aortic Valve Insufficiency ; Cardiomegaly ; Cause of Death ; Coronary Vessels ; Dyspnea ; Endocarditis ; Estrogens, Conjugated (USP) ; Fever ; Heart Failure ; Heart Murmurs ; Heart Ventricles ; Heart ; Myocardial Infarction ; Myocarditis ; Respiratory Sounds ; Systolic Murmurs ; Thorax ; Viridans Streptococci

Aneurysm of the pulmonary artery is a rare entity. Aneurysm of the peripheral artery are even less common. An 14-year-old girl was admitted for the evaluation of cardiac murmur. There was a variable grade 2/6 systolic murmur along the left sternal border. The chest x-ray showed a round mass in the right perihilar region. Echocardiogram demonstrated a small muscular ventricular septal defect with mild tricuspid regurgitation. The pulmonary arterial pressures were normal at cardiac catheterization, but pulmonary angiography indicated an aneurysm of the intrapulmonary portion of the right pulmonary artery. Surgical intervention was advised. However, the patient discharged againt operative plan. The literature on this entity is reviewed, and the diagnosis and etiology are discussed.
Adolescent ; Aneurysm* ; Angiography ; Arterial Pressure ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Female ; Heart Murmurs ; Heart Septal Defects, Ventricular ; Humans ; Hypertension, Pulmonary* ; Pulmonary Artery* ; Systolic Murmurs ; Thorax ; Tricuspid Valve Insufficiency

A 38-year old female was admitted to our hospital for further evaluation of an incidentally found cardiac murmur. She had been in a hypertensive state for 5 years but had taken antihypertensive drugs intermittently on her own. Her history revealed that she had become amenorrheic for 7 months and had, had headaches for a few months. Physical examination revealed central obesity and a moon face, but no hirsuitism. When she first visited our hospital, her blood pressure was 260/170 mmHg and grade 2 systolic murmur was audible along the left sternal border. Laboratory studies revealed high levels of 24-hour urine-free cortisol and plasma aldosterone, but a very low level of plasma adrenocorticotropic hormone and plasma renin activity. A low-dose and a high-dose dexamethasone suppression tests, adrenal venous sampling, inferior petrosal sinus sampling, and a renin stimulation test were performed. Bilateral adrenal masses were found on computerized tomographic scanning and magnetic resonance imaging but there was no abnormality of the pituitary gland. The uncontrollable blood pressure and the elevated 24-hour urine-free cortisol and plasma aldosterone levels were corrected by a right-total and left-subtotal adrenalectomy. Pathologic findings were bilateral adrenal cortical adenomas of different cell types. These findings indicate that the adrenal cortical adenomas were tumors that functioned differently, causing Cushing's syndrome and primary aldosteronism in the same patient. A review of, the literature published in English showed that this is the first reported case, of bilateral adrenal adenomas functioning differently.
Adenoma ; Adrenalectomy ; Adrenocortical Adenoma* ; Adrenocorticotropic Hormone ; Adult ; Aldosterone ; Antihypertensive Agents ; Blood Pressure ; Cushing Syndrome* ; Dexamethasone ; Female ; Headache ; Heart Murmurs ; Humans ; Hydrocortisone ; Hyperaldosteronism* ; Magnetic Resonance Imaging ; Obesity, Abdominal ; Petrosal Sinus Sampling ; Physical Examination ; Pituitary Gland ; Plasma ; Renin ; Systolic Murmurs

No abstract available.
Anticoagulants ; Echocardiography, Transesophageal ; Embolism ; Endocarditis ; Endocarditis, Bacterial ; Heart Valve Prosthesis ; Heart Ventricles ; Hemodynamics ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Outpatients ; Pneumonia ; Systolic Murmurs ; Warfarin ; Humans

A 6-month-old mature intact female Siamese cat presented with exertional dyspnea. Diagnostic studies revealed pleural effusion, grade 4/6 left basal systolic murmur, deep S-wave in electrocardiograph leads I, II, and III, cardiomegaly with pleural effusion on radiography, pulmonic systolic (~5.8 m/sec) and tricuspid (3.6 m/sec) regurgitant jets, atrial septal defect, and a hypoplastic right outflow tract. Based on these results, the case was diagnosed as pulmonic stenosis with atrial septal defect. To the best of our knowledge, this is the first case report describing pulmonic stenosis with atrial septal defect in a cat in Korea.
Animals ; Cardiomegaly ; Cats* ; Dyspnea ; Electrocardiography ; Female ; Heart Defects, Congenital ; Heart Septal Defects, Atrial* ; Humans ; Infant ; Korea ; Pleural Effusion ; Pulmonary Valve Stenosis* ; Radiography ; Systolic Murmurs