No abstract available.
Chest Pain ; Echocardiography ; Esophageal Achalasia ; Heart Atria ; Humans ; Thorax

No abstract available.
Endocarditis ; Sinus of Valsalva

Although cardiac papillary fibroelastoma is rare, it is the most common primary tumor of cardiac valves. The clinical presentation of these tumors varies from asymptomatic to embolic complications. We report an asymptomatic case of papillary fibroelastoma of mitral valve which was diagnosed by transthoracic echocardiography. The tumor was successfully resected by surgery.
Echocardiography ; Heart Valves ; Mitral Valve

A 53-year-old man complained of orthostatic, non-rotating dizziness, and chronic watery diarrhea of several years duration. His nerve-conduction velocity test revealed peripheral sensory-motor polyneuropathy and he showed an autonomic function abnormality. Echocardiographic examination showed ventricular and atrial wall thickening with a granular "sparkling" appearance. Left ventricular systolic function was preserved but pseudonormal diastolic dysfunction was present. Coronary angiography showed normal coronary arteries and an endomyocardial biopsy revealed lesions consistent with cardiac amyloidosis. Colonoscopic biopsy also revealed the deposition of amyloid fibrils. Gene analysis found the transthyretin variant Asp38Ala. His son had same mutation, but three daughters did not. In conclusion, we report a case of familial transthyretin amyloidosis with Asp38Ala.
Amyloid ; Amyloid Neuropathies, Familial ; Amyloidosis ; Biopsy ; Coronary Angiography ; Coronary Vessels ; Diarrhea ; Dizziness ; Hypotension, Orthostatic ; Nuclear Family ; Polyneuropathies ; Prealbumin

Carbon monoxide is a nonirritant, odorless, colorless gas. Its effects are prominent in organs most sensitive to oxygen deprivation, such as the heart, brain, and kidney. Although less frequently, an association between thromboembolic events and carbon monoxide poisoning has been shown in the literatures. In this case, we report a case of atrial thrombus associated with carbon monoxide poisoning.
Brain ; Carbon ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Heart ; Heart Atria ; Kidney ; Oxygen ; Thrombosis

Embolization of the closure device is a rare but potentially fatal complication of percutaneous atrial septal defect (ASD) closure. We report a case of 45-year-old woman who underwent ASD device closure with 32 mm Amplatzer device, which was embolized to the pulmonary artery without symptom one day after successful device implantation.
Female ; Heart Septal Defects, Atrial ; Humans ; Pulmonary Artery ; Septal Occluder Device

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly associated with very high mortality during infancy. We report a 35-year-old female patient with ALCAPA initially visualized by echocardiography. She visited outpatient department presenting with intermittent chest discomfort for 3 weeks. Transthoracic echocardiography showed left coronary artery arising from main pulmonary artery and abundant septal color flow Doppler signals. Transesophageal echocardiography clearly revealed markedly dilated and tortuous right coronary artery showing windsock appearance. Multidetector computed tomography and coronary angiography enabled visualization of anomalous left coronary artery originating from left side of main pulmonary trunk. After treadmill exercise test which showed ST-segment depression presenting inducible myocardial ischemia, patient underwent direct re-implantation of the anomalous coronary artery into the aorta without any complication.
Aorta ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels ; Depression ; Echocardiography ; Echocardiography, Transesophageal ; Exercise Test ; Female ; Humans ; Multidetector Computed Tomography ; Myocardial Ischemia ; Outpatients ; Pulmonary Artery ; Thorax

Cardiac calcification usually occurs in patients with end-stage renal disease. However, rapid progression of cardiac calcification is rarely associated with secondary hyperparathyroidism of end-stage renal disease. We report a patient with end-stage renal disease who showed moderate left ventricular hypertrophy at the first echocardiography, and showed severe myocardial calcification and severe mitral valve stenosis 4 years later. We suspected a rapid progression 'porcelain heart' cardiomyopathy secondary to hyperparathyroidism of end-stage renal disease. The patient underwent parathyroidectomy, and considered mitral valve replacement.
Cardiomyopathies ; Dental Porcelain ; Echocardiography ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Mitral Valve ; Mitral Valve Stenosis ; Parathyroidectomy ; Renal Dialysis

Takayasu's arteritis is a chronic inflammatory disorder that mainly involves medium to large sized arteries. Although pulmonary artery involvement is reported with a prevalence of about 10% to 50%, its clinical significance is underestimated. We report here one case of Takayasu's arteritis complicated by severe pulmonary hypertension due to right main pulmonary artery total occlusion.
Arteries ; Humans ; Hypertension, Pulmonary ; Prevalence ; Pulmonary Artery ; Takayasu Arteritis ; Tricuspid Valve Insufficiency

BACKGROUND: Measurement of right ventricular (RV) systolic function is important for patients with acute pulmonary embolism (PE). However, assessment of RV function is a challenge due to its complex anatomy. We measured RV systolic function with analysis of tricuspid annular motion in acute PE patients. METHODS: From August 2007 to May 2011, all consecutive PE patients were prospectively included. Tricuspid annular motion was analyzed with tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (TASV). RESULTS: We analyzed total 50 patients (38 females, 68 +/- 14 years). Mean RV fractional area change (RVFAC) was 26.2 +/- 10.8%; RV Tei index 0.78 +/- 0.35; TR Vmax 3.8 +/- 0.5 m/sec; pulmonary vascular resistance (PVR) 3.5 +/- 1.2 WU. TAPSE was 16 +/- 4 mm and TASV was 11.7 +/- 4.0 cm/sec. TAPSE showed significant correlations with RVFAC (r = 0.841, p < 0.001), RV Tei index (r = -0.347, p = 0.018), Log B-type natriuretic peptide (BNP) (r = -0.634, p < 0.001) and PVR (r = -0.635, p < 0.001). TASV also revealed significant correlations with RVFAC (r = 0.605, p < 0.001), RV Tei index (r = -0.380, p = 0.009), LogBNP (r = -0.477, p = 0.001) and PVR (r = -0.483, p = 0.001). The best cutoff of TAPSE for detection of RV systolic dysfunction (defined as RVFAC < 35%) was 1.75 cm [Areas under the curve (AUC) = 0.96, p < 0.001] with a sensitivity of 87% and specificity 91%. The best cutoff for TASV was 13.8 cm/sec (AUC = 0.90, p < 0.001), sensitivity 86% and specificity 78%. However, there was no statistical significance in the detection of RV dysfunction (difference = 0.07, 95% CI = -0.21-0.17, p = 0.130) between TAPSE and TASV. CONCLUSION: TAPSE and TASV showed significant correlations with conventional echocardiographic parameters of RV function and LogBNP value. These values can be used to detect RV systolic dysfunction more easily in patients with acute PE.
Echocardiography ; Female ; Heart Ventricles ; Humans ; Natriuretic Peptide, Brain ; Prospective Studies ; Pulmonary Embolism ; Sensitivity and Specificity ; Vascular Resistance