The risk factors of abdominal aortic aneurysm (AAA) are old age, atherosclerosis, hypertension, smoking and family history of AAA. And the risk factors of aortic dissection are old age, atherosclerosis, hypertension and other aortic diseases such as aortic aneurysm, coarctation of aorta, aortic arteritis and bicuspid aortic valve. Although AAA and aortic dissection shares common risk factors, combination of these two disease are very uncommon. We report a case of 69-year-old female presented with chronic ascending aortic dissection combined with infrarenal AAA with a diameter of 7 cm and a case of 73-year-old-male presented with intramural hematoma of descending thoracic aorta combined with infrarenal AAA with a diameter of 6 cm.
Aged ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Aortic Coarctation ; Aortic Diseases ; Aortic Valve ; Arteritis ; Atherosclerosis ; Bicuspid ; Female ; Hematoma ; Humans ; Hypertension ; Risk Factors ; Smoke ; Smoking

Primary tumors of the heart are rare, three-quarters of the tumors are benign, and nearly half of the benign heart tumors are myxomas. Cardiac myxoma usually originate in the left atrium about 75 percent, but, only 3 to 4 percent of myxoma are detected in the left ventricle. Cardiac myxoma is histologically benign, but may be lethal because of their position. We reported a case of 65-year-old man with left atrium myxoma associated with inferior vena caval thrombi and pulmonary embolism. After the operation of myxoma, the Budd-Chiari syndrome developed and the patient died due to hepatic failure.
Aged ; Budd-Chiari Syndrome* ; Heart ; Heart Atria* ; Heart Neoplasms ; Heart Ventricles ; Humans ; Liver Failure ; Myxoma* ; Pulmonary Embolism* ; Thrombosis*

Isolated noncompaction of the left ventricular myocardium is a rare cardiac disorder due to an arrest in myocardial morphogenesis. It is characterized by prominent and excessive trabeculation in a ventricular wall segment, with deep intertrabecular spaces perfused from the ventricular cavity. Echocardiographic findings are important clues for the diagnosis. Clinical symptoms include signs of left ventricular systolic dysfunction even to the point of heart failure, ventricular arrhythmias, and embolic events. We describe two cases of isolated noncompaction of the myocardium, with ventricular tachycardia in one, and chest pain due to microvascular dysfunction in the other.
Adult* ; Arrhythmias, Cardiac ; Chest Pain ; Diagnosis ; Echocardiography ; Heart Failure ; Humans ; Morphogenesis ; Myocardium* ; Tachycardia, Ventricular

Primary pulmonary hypertension is a condition characterized by sustained elevations of pulmonary artery pressure without demonstrable cause. It is incurable and progressive clinical entity. The incidence has been estimated at approximately 1 to 2 cases per million people in the general population. The maternal mortality of primary pulonary hypertension in pregnancy was said to be 30% and the first month after delivery represents the period of highest risk. We experienced a 27-year-old women with primary pulmonary hypertension diagnosed in postpartum period. She was transferred from the department of obstetrics to internal medicine due to dyspnea on the first day of postpartum. She was diagnosed by perfusion lung scan, chest CT and confirmed by echocardiography. This diagnosis were supported by findings of pulmonary angiogram and cardiac catheterization. Initially she was treated with diuretics, aspirin and anticoagulant therapy, and as a result of the treatment, her symptoms improved. However after 8months has elapsed, exertional dyspnea was worsening. Thus she was treated with calcium channel blocker, aspirin and diuretics and was followed at 1 month interval on the outpatient clinics.
Adult ; Ambulatory Care Facilities ; Aspirin ; Calcium Channels ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Diuretics ; Dyspnea ; Echocardiography ; Female ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Incidence ; Internal Medicine ; Lung ; Maternal Mortality ; Obstetrics ; Perfusion ; Postpartum Period* ; Pregnancy ; Pulmonary Artery ; Tomography, X-Ray Computed

Obstructive myxoma of the right ventricular outflow tract occurs rarely. A 22-year-old woman presented with a 3-month history of shortness of breath during exertion. Transthoracic echocardiography showed a huge mass in a dilated right ventricle. The mass, which obstructed the right ventricular outflow tract, was attached to the interventricular septum and protruded through the pulmonic valve during systole. The peak and mean systolic pressure gradients across the pulmonic valve were 79.9 and 47.8 mmHg, respectively. At surgery, the origin of the mass was attached to the right ventricular apex on its septal surface. The histopathological findings were characteristic of myxoma. The patient recovered uneventfully.
Blood Pressure ; Dyspnea ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Myxoma* ; Pulmonary Artery* ; Systole ; Ventricular Outflow Obstruction ; Young Adult

Sinus of Valsalva aneurysm is postulated to arise from a developmental weakness in the distal bulbar septum by Abbott in 1919. Additionally, properly shaped sinuses will allow stress sharing with the leaflets. The sinus of Valsalva aneurysm is combined with valvular aneurysm is very rare. This anomaly is a very rare and can be confirmed by echocardiography, angiography and operative finding. Clinically, patients complain with the symptom, but surgical approach including aneurysmectomy with patch repain for the tissue defect is recommend to abolish fatal outcome due to intracardiac or extracardiac rupture of aneurysm and fatal deterioration of valvular heart disease. A 48-year-old man presented mild dyspnea and was diagnosed of having a noncoronary cusp and sinus of Valsalva aneurysm by echocardiography. He underwent prosthetic aortic valve replacement and vessel repair with patch of pericardial membrane.
Aneurysm* ; Angiography ; Aortic Valve* ; Dyspnea ; Echocardiography ; Fatal Outcome ; Heart Valve Diseases ; Humans ; Membranes ; Middle Aged ; Rupture ; Sinus of Valsalva*

Primary myxoid liposarcoma of the heart is very rare. Following is a report on a 35 year old male presented with a huge, 8x8 cm sized mass along the inferior wall of right ventricle. The histologic diagnosis of the mass was primary myxoid liposarcoma of the pericardium. The patient died 5 months after diagnosis due to progressive dyspnea.
Adult ; Diagnosis ; Dyspnea ; Heart ; Heart Ventricles ; Humans ; Liposarcoma, Myxoid* ; Male ; Pericardium*

Primary cardiac tumors in infancy and childhood are rare, with fibromas being the second most common tumor after rhabdomyomas. Although cardiac fibromas are characteristically benign intramural tumors, they may exhibit expansile growth resulting in obstruction, valvular dysfunction, as well as other problems so early diagnosis and successful surgical excision are important. We experienced a case of cardiac fibroma in right ventricle that diagnosed by transthoracic echocardiography, chest CT, open heart tissue biopsy etc.
Biopsy ; Early Diagnosis ; Echocardiography ; Fibroma* ; Heart ; Heart Neoplasms ; Heart Ventricles ; Rhabdomyoma ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Transient tirglyceridemia decrease vascular reactivity. The aim of this project is to assess the difference in coronary blood flow and coronary blood flow reserve (CFR) after a single High-Fat (HFM) and a Low-Fat meal (LFM) in patients with ischemic heart disease (IHD). METHOD: We included eleven patients with IHD (mean age : 57.2+/-9.5) and excluded significant lesion of left anterior descending artery (more than 60%). We examined blood pressure, pulse rate, blood glucose, total cholesterol, triglyceride, High density lipoprotein-cholesterol (HDL-C) before and 120 minutes after HFM and LFM. Coronary blood flow and CFR of the left anterior descending artery was determined by transthoracic Doppler echocardiography at the same time. Maximal vasodilating activity was obtained 3 to 5 minutes after adenosine infusion at the rate of 140 ug/kg/min. The percentages of total lipid at HFM and LFM were respectively 64% (513 kcal/803 kcal) and 16% (126 kcal/800 kcal). RESULT: Serum triglyceride increased from 153.0+/-78.7 mg/dL preprandially to 228.5+/-95.4 mg/dL after HFM (p<0.01). Serum triglyceride after HFM was higher than after LFM (166.4+/-67.4 mg/dL, p<0.05). Serum glucose increased from 97.2+/-18.8 mg/dL preprandially after LFM and HFM (152.6+/-38.0 mg/dL, 123.8+/-30.8 mg/dL, p<0.05). Serum glucose after LFM was higher than after HFM (p<0.01). The maximal and mean diastolic velocity of coronary flow at fasting (22.5+/-5.5 cm/sec, 17.8+/-4.3 cm/sec) increased after LFM (25.9+/-5.9 cm/sec, 20.2+/-5.3 cm/sec, p<0.01, p<0.05), and not increased after HFM significantly (24.5+/-4.6 cm/sec, 19.5+/-3.3 cm/sec). The CFR was 2.01+/-0.81 at fasting, 1.97+/-0.72 after LFM and 2.05+/-0.58 after HFM. There was no significant diffterence in CFR related to the diet. CONCLUSION: In patient with IHD, CFR may not be affected by HFM and LFM. There was increasing tendency of the coronary blood flow after diet, especially by LFM. This is potential mechanism of postprandial angina.
Adenosine ; Arteries ; Blood Glucose ; Blood Pressure ; Cholesterol ; Diet ; Echocardiography* ; Echocardiography, Doppler ; Fasting ; Heart Rate ; Humans ; Meals* ; Myocardial Ischemia* ; Triglycerides

BACKGROUND AND OBJECTIVES: Coronary artery disease (CAD) is the leading cause of death in postmenopausal women, and exercise echocardiography was reported to be a useful noninvasive test for diagnosis of CAD and risk-stratification in the era of fundamental echocardiographic imaging. This study was performed to determine whether normal findings on exercise echocardiography using advanced imaging equipments such as harmonic imaging provide useful data on prognosis in postmenopausal women with chest pain. METHOD: The study population consisted of 102 patients with postmenopausal women who were proven to be normal on exercise echocardiography from August 1997 to January 1999. Patients were followed up for a mean duration of 3.5 years. These patients were classified into 3 groups on existence of risk factors; low-risk, moderate-risk, high-risk. End points during follow-up were all-cause mortality and cardiac events (cardiac death, nonfatal myocardial infarction and coronary revascularization). We studied the prognostic value of exercise echocardiography in 102 patients of postmenopausal women with chest pain (mean age 59+/-6 years). RESULT: Of these 102 patients, 1 patient (0.1%) among the high-risk group underwent coronary revascularization and 2 patients (1.9%) among low- and moderate-risk group died of non-cardiac reasons. No cardiac deaths or nonfatal myocardial infarction were reported. According to risk group classification, there was no difference in major adverse cardiac events between each risk groups. ST segment change on exercise electro-cardiography was observed in 7 patients (7%). CONCLUSION: Normal results on exercise echocardiography using harmonic imaging in postmenopausal women with chest pain is a good method of predicting long-term prognosis.
Cause of Death ; Chest Pain ; Classification ; Coronary Artery Disease ; Death ; Diagnosis ; Echocardiography* ; Female ; Follow-Up Studies ; Humans ; Mortality ; Myocardial Infarction ; Prognosis ; Risk Factors