Cardiology
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This study assessed the usefulness of continuous wave Doppler echocardiography and color flow mapping in evaluating pulmonary regurgitation (PR) and estimating pulmonary artery (PA) pressure. Forty-three patients were examined, and high quality Doppler spectral recordings of PR were obtained in 32. All patients underwent cardiac catheterization, and simultaneous PA and right ventricular (RV) pressures were recorded in 17. ⋯ Moreover, the Doppler velocity decay slope of PR closely correlated with that derived from the catheter method (r = 0.98). The decay slope tended to be steeper with the increment in regurgitant jet area and length obtained from color flow mapping. In conclusion, continuous wave Doppler evaluation of PR is a useful means for noninvasive estimation of PA pressure, and the Doppler velocity decay slope seems to reflect the severity of PR.
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In a 79-year-old female with shortness of breath, catheterization via the femoral vein encountered difficulty entering the right heart; venography revealed anomalous drainage of the inferior vena cava via a dilated azygos vein permitting subsequent catheterization. Similar difficulties during catheterization merit consideration of this congenital anomaly, which is virtually always discovered in the pediatric population in association with other congenital anomalies. Its unique discovery at advanced age indicates its benignity as an isolated abnormality.
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Comparative Study
Lack of a thrombotic tendency in patients with acute myocardial infarction and angiographically normal coronary arteries.
The hematological profile of 12 patients with acute myocardial infarction and normal coronary arteriographic findings was compared to that of 8 patients with acute myocardial infarction associated with obstructive coronary artery disease, and of 12 patients with no evidence of myocardial infarction and normal coronary arteriographic and left ventriculographic findings who served as control. There were no significant differences in the hematological profile among the 3 groups, suggesting lack of a thrombotic tendency in patients with acute myocardial infarction and normal coronary arteriographic findings.
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Case Reports
Transesophageal echocardiography as an important tool in the diagnosis of postinfarction papillary muscle rupture.
Papillary muscle complicating acute myocardial infarction is an uncommon but potentially catastrophic event. We present 3 such cases to illustrate the difficulties in early identification of rupture. In each case, transesophageal echocardiography was employed providing rapid and unequivocal identification of the disorder. Prompt surgical intervention led to survival in 2 patients.
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The aim of this study was to assess the performance of pediatric-size oximetry catheters in diagnostic heart catheterization. Measurements of pressures and oxygen saturations were obtained with oximetry catheters as well as with standard methods during routine heart catheterizations in 10 infants and children with congenital heart defects. ⋯ Oxygen saturation measurements exhibited bias and scatter. It is concluded that no advantage is obtained by the use of oximetry catheters in diagnostic heart catheterization in children and infants.