Multiple echo views in EMF

Parasternal long axis (PLAX) view being the first view taken in most echocardiographic studies, gives this image with dilated right ventricular outflow tract (RVOT). This pattern alone will not give a suspicion of endomyocardial fibrosis (EMF) as RVOT can be dilated along the with the rest of the right ventricle in conditions causing right ventricular volume overload like an atrial septal defect as well as in Ebstein’s anomaly of the tricuspid valve. Conditions with a dilated RVOT will have a characteristic clinical finding of RVOT pulsations, along the left sternal border, in the third intercostal space. Pulsation is not associated with a heave in conditions like Ebstein’s anomaly and right ventricular EMF, where the right ventricular pressures are not elevated. LA: Left atrium; Ao: Aorta; LV: Left ventricle. This image from a modified apical four chamber view shows the characteristic fibrosis and obliteration of right ventricular apex in EMF along with a dilated right atrium (RA). RV: Right ventricle. Right ventricular cavity is not much dilated. Another image from a modified apical four chamber view shows the characteristic dimple at right ventricular apex due to the fibrotic process along with a small encysted effusion nearby. The long standing exudate in the pericardial space has been organized into a clot like structure. Dilated right atrium and the fibrosis at RV apex are visible. As the prevalence of EMF is coming down drastically, such images are rarely...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Echocardiogram Library Echocardiography Source Type: blogs

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AbstractObjectivesIn type II atrial septal defect (ASD) patients, the left-to-right (LR) shunt causes adaptation of the heart and circulation. The study objective was to evaluate with cardiovascular magnetic resonance imaging (CMR) the impact of LR shunt on left (LV) and right ventricular (RV) volumes, function, and myocardial strain.MethodsThirty-five patients (42  ± 17 years, 17 male) were compared to a control group (n = 40). Cine imaging was used to calculate ventricular volumes and ejection fraction (EF), global longitudinal (GLS) and circumferential strain (GCS), and longitudin...
Source: European Radiology - Category: Radiology Source Type: research
Authors: Kim S, Cho YH, Park PW, Lee YT, Jun TG, Kim WS, Sung K, Yang JH, Chung S Abstract A 59-year-old man presented for possible durable ventricular assist device (VAD) implantation. He had previously been diagnosed with congenitally corrected transposition of the great arteries, a ventricular septal defect, an atrial septal defect, pulmonary valve stenosis, and aortic valve regurgitation. In the previous 22 years, he had undergone palliative cardiac surgery 3 times. VAD implantation as a bridge to transplantation was planned. Owing to severe adhesions, mesocardia, a left ascending aorta, and moderate aortic reg...
Source: Korean Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research
AbstractIn this review, we provide a brief description of recently published articles addressing topics relevant to pediatric cardiologists. Our hope is to provide a summary of the latest articles published recently in other journals in our field. The articles address (1) outcomes after anomalous aortic origin of the coronary artery repair which showed relief of ischemia in most patients with low mortality, (2) the role of lymphatic imaging to predict post-Fontan complications which showed that lymphatic imaging by MRI may have an added prognostic value, (3) European guidelines for participation in competitive sports in co...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
Authors: SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY, Scavone M, Tallarico V, Stefanelli E, Parisi F, De Sarro R, Salpietro C, Ceravolo G, Sestito S, Pensabene L, Chimenz R, Calabrò MP, Gitto E, Giancotti L, Concolino D Abstract Congenital hypothyroidism (CH) is the most common endocrine disease in children, according to literature, infants with CH have an increased risk of associated congenital malformations (CM), especially cardiac defects (CD), compared to the general population. We retrospectively analyzed medical records of 255 patients with a positive screening result for CH in the period 1991-2016 fo...
Source: Journal of Biological Regulators and Homeostatic Agents - Category: Biomedical Science Tags: J Biol Regul Homeost Agents Source Type: research
PMID: 33016689 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
Atrial enlargement  The normal P wave has a maximum amplitude of 2.5 mm (0.25 mV) and a maximum width of 2.5 mm (100 ms). In right atrial enlargement, the amplitude increases while in left atrial enlargement, it is the width (duration) which increases. Both increases in biatrial enlargement. P wave abnormalities are best assessed in leads II and V1. Normal P wave is upright in lead II. In V1, a tiny initial spike is followed by a shallow negative wave. P mitrale: P mitrale is a notched and broad P wave with taller second peak indicating left atrial enlargement. It may be noted that initial part of P wave is contribut...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: HBC incomplete right bundle branch block pattern Left ventricular pressure overload left ventricular volume overload LVH strain pattern P mitrale P pulmonale P tricuspidale Right ventricular pressure overload right ventricular volume ove Source Type: blogs
Authors: Vanreusel I, Maes S, De Wolf D, Van Berendoncks A Abstract Atrial septal defects (ASDs) are the third most common type of congenital heart diseases with ostium secundum defects (ASDsII) being responsible for approximately 75% of these defects. The treatment consists of either a transcatheter closure or a surgical intervention. The transcatheter approach offers a less invasive alternative for patients who fulfill anatomical and size criteria and is therefore increasingly used as the preferred primary intervention. As general anaesthesia is sometimes contra-indicated for some patients needing ASD or PFO clos...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
Two normally heard heart sounds are the first heart sound (S1) and second heart sound (S2). Second heart sound has two components – aortic (A2) and pulmonary (P2). Normal A2 is heard in all auscultatory areas while normal P2 is heard only in the pulmonary area. If it is heard at the apex, it can be considered as loud P2. Normal split of second heart sound closes in expiration and is audible only in inspiration. If it is audible in both inspiration and expiration, it is called wide split. If the split increases in expiration and closes in inspiration, it is paradoxical split. Wide fixed split is audible in both inspi...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: HBC Paradoxical splitting of second heart sound sail sound Wide fixed split wide split Source Type: blogs
Palpation initially confirms the findings of inspection and further looks for new findings. Apex beat: Apex beat is defined as the lowest and outer most point of definite cardiac impulse. If apex beat is not felt on left side, immediately check on right side or else we might miss a dextrocardia. There some who even palpate both sides simultaneously for this reason. Apex beat is initially felt with the palm of the hand and then localized with the index finger. Sometimes it may be difficult to palpate in obese individuals and in those with emphysema. Palpation in held expiration and in the left lateral position may help in...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: HBC Source Type: blogs
AbstractSerial changes of electrocardiograms (ECG) could be used to assess their clinical features in atrial septal defects (ASD) after transcatheter closure together with other clinical parameters. We retrospectively studied 100 ASD patients who underwent transcatheter closure. Complications of persistent atrial fibrillation occurred in five ASD patients, and they were excluded. We divided the other 95 patients according to PQ intervals before closure (normal:  
Source: Heart and Vessels - Category: Cardiology Source Type: research
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