Introduction: Congenitally corrected transposition of the great arteries (cc-TGA) is a congenital heart disease rarely described among adult population, especially if it is associated with other abnormalities such as ...Introduction: Congenitally corrected transposition of the great arteries (cc-TGA) is a congenital heart disease rarely described among adult population, especially if it is associated with other abnormalities such as Ebstein’s anomaly and abnormal origin of coronary arteries. Case presentation: Twenty-two-year-old woman admitted to intensive care unit with acute decompensated heart failure. The transthoracic echocardiography demonstrated atrioventricular and ventriculoarterial discordance. The left-sided atrioventricular valve, in this case, the tricuspid valve, showed apical displacement of the septal valve suggesting Ebstein’s anomaly. The computed tomography corroborated these findings and additionally showed a left superior vena cava and an abnormal origin of the coronary arteries. The patient is in NYHA functional class II, receiving treatment with diuretic, digitalis, beta-blockers and angiotensin-converting enzyme (ACE) inhibitor. Conclusion: This is a very interesting case of an adult in the third decade of life with cc-TGA associated with abnormalities not described in the literature that had reached adulthood. Noninvasive images play an important role in its diagnosis.展开更多
Rationale: Pompholyx refers to pruritic vesicles or bullous rash that mainly distribute on the palms and lateral surfaces of the fingers. It is less common among Asians, and in a severe condition, secondary bacterial ...Rationale: Pompholyx refers to pruritic vesicles or bullous rash that mainly distribute on the palms and lateral surfaces of the fingers. It is less common among Asians, and in a severe condition, secondary bacterial infection of pompholyx can happen and result in pain, swelling and pustules.Patient concerns: A 15-year-old girl complained of progressive wound and small bumps containing yellowish pus and crusts on her hands and feet for over 6 months and worsened in the last month before admission. She also had Ebstein anomaly.Diagnosis: Atypical pompholyx with secondary Staphylococcus and Klebsiella infections. Interventions: Wound care with wet dressing and applying moisturizer on crusts, application of antibiotics for Gram positive and negative bacteria and giving nutritional support with reckoning of proper calories. Outcomes: Skin lesions were completely healed and the patient was discharged after 10 days of hospitalization.Lessons: Atypical manifestation of pompholyx makes it hard to diagnose. The diagnosis can be confirmed with meticulous historytaking and physical examination. Wound caring and controlling of the infection should be done to earn an optimal outcome.展开更多
Ebstein’s anomaly is a rare congenital heart disease. We report a series of 4 cases of Ebstein’s anomaly discovered in adolescents. The mean age was 13.75 ± 0.96, with 3 boys and one girl. Three ...Ebstein’s anomaly is a rare congenital heart disease. We report a series of 4 cases of Ebstein’s anomaly discovered in adolescents. The mean age was 13.75 ± 0.96, with 3 boys and one girl. Three were in heart failure. The EKG showed atrial hypertrophy (1 case), right bundle branch block (1 case), Wolff-Parkinson-White (1 case), and atrial fibrillation (1 case). Cardiomegaly was present in all patients with a mean cardiothoracic index of 0.77 ± 0.03. On echocardiography, the mean apical displacement of the tricuspid septal leaflet was 22.5 ± 3.30 mm/m<sup>2</sup>, the Celermajer index was Grade 2 in 2 patients and Grade 4 in 2 patients. Depletive medical treatment was prescribed to 3 patients. Anticoagulant therapy was initiated in one patient. Two are awaiting surgery. One death was recorded, it was at Grade 4 of the Celermajer index.展开更多
Main pulmonary artery aneurysms are rare,mostly asymptomatic and discovered accidentally.The main pulmonary artery aneurysms may be idiopathic or secondary to underlying diseases such as pulmonary hypertension,Behcet...Main pulmonary artery aneurysms are rare,mostly asymptomatic and discovered accidentally.The main pulmonary artery aneurysms may be idiopathic or secondary to underlying diseases such as pulmonary hypertension,Behcet’s disease,connective tissue disorders,congenital heart disease,vasculitis,syphilis,tuberculosis and endocarditis.There are some indices that dextrocardia is associated with anomalies of the pulmonary arteries and pulmonary valve.A rare occurrence of main pulmonary artery aneurysms results in a lack of recommendations,so the remaining challenges are whether main pulmonary artery aneurysms should be treated,how,and when.The decision on surgical intervention or conservative treatment of the main pulmonary artery aneurysms depends on its size,etiology and accompanying diseases and includes a multidisciplinary heart team.Our case of the main pulmonary artery aneurysm and pulmonary valve abnormality associated with Ebstein anomaly and dextrocardia in a 67-year-old male patient brings causality considerations and treatment options in such a unique condition.展开更多
Ebstein's anomaly(EA) is a rare cardiac congenital malformation with displacement of septal and posterior tricuspid leaflets,resulting in atrialization of the right ventricle.We report a case of EA in which the et...Ebstein's anomaly(EA) is a rare cardiac congenital malformation with displacement of septal and posterior tricuspid leaflets,resulting in atrialization of the right ventricle.We report a case of EA in which the etiology of a malfunctioning prosthetic tricuspid valve is depicted on cardiac computed tomography to be as a result of thrombus lodged in the valve.展开更多
Ebstein disease is a rare congenital malformation whose clinical presentation differs according to the anatomical form and age of the patient. In adults, it presents mainly in the form of right or global heart failure...Ebstein disease is a rare congenital malformation whose clinical presentation differs according to the anatomical form and age of the patient. In adults, it presents mainly in the form of right or global heart failure or rhythm disorders. Survival is exceptionally long in some forms. We report the case of a 70-year-old patient with Ebstein’s disease in right heart failure.展开更多
Among all congenital heart disease,Ebstein anomaly is the lesion with the widest spectrum of presentation.It can present as early as the neonatal period where immediate intervention is often needed to the adult with n...Among all congenital heart disease,Ebstein anomaly is the lesion with the widest spectrum of presentation.It can present as early as the neonatal period where immediate intervention is often needed to the adult with no discernable symptoms.It is also one where overall outcome greatly relates to age at presentation.Generally,presentation in the neonatal period is associated with poor outcomes while presentation beyond the neonatal period has excellent outcomes with low operative mortality.It is thus apparent that understanding every aspect of the anatomy and physiology of Ebstein anomaly and how it manifests clinically is paramount to successful treatment.The purpose of this review is to outline the current concepts and strategies in the surgical management of Ebstein anomaly,and to discuss the current expert consensus on how best to tackle this congenital heart disease at different ages of diagnosis.展开更多
Aim: To present the various echocardiographic spectrum of Ebstein’s mal-formation in adolescence and adults. Introduction: Ebstein’s anomaly has different anatomic and hemodynamic variables with clinical manifestati...Aim: To present the various echocardiographic spectrum of Ebstein’s mal-formation in adolescence and adults. Introduction: Ebstein’s anomaly has different anatomic and hemodynamic variables with clinical manifestations of cyanosis, right-sided heart failure and arrhythmias. The leaflet tethering and dysplasia, together with dilatation of the tricuspid valve ring, constitute the anatomic cause of tricuspid regurgitation observed in this condition. Case Reports: The spectrum of leaflet tethering from mild to extreme with varying degrees of tricuspid regurgitation were documented by echocardiography in a 16-year-old cyanotic male with Ebstein’s anomaly associated with an atrial septal defect and mild low tricuspid regurgitation (TR), 22-year-old acyanotic male with right-sided heart failure due to severe tricuspid regurgitation and an intact atrial septum, 55-year-old asymptomatic female with moderate high tricuspid regurgitation. The extreme form was described as an “atretic” mem-brane in a 28-year-old cyanotic male and as a “blanket” of leaflet tissue in a 30-year-old cyanotic male. Conclusion: Ebstein’s anomaly has to be sus-pected clinically in presence of cyanosis with a WPW (Wolf-Parkinson-White) or atrioventricular (AV) block pattern of ECG and its management is complex and must be individualized. RV (right ventricular) exclusion procedures are preferred in advanced cases.展开更多
文摘Introduction: Congenitally corrected transposition of the great arteries (cc-TGA) is a congenital heart disease rarely described among adult population, especially if it is associated with other abnormalities such as Ebstein’s anomaly and abnormal origin of coronary arteries. Case presentation: Twenty-two-year-old woman admitted to intensive care unit with acute decompensated heart failure. The transthoracic echocardiography demonstrated atrioventricular and ventriculoarterial discordance. The left-sided atrioventricular valve, in this case, the tricuspid valve, showed apical displacement of the septal valve suggesting Ebstein’s anomaly. The computed tomography corroborated these findings and additionally showed a left superior vena cava and an abnormal origin of the coronary arteries. The patient is in NYHA functional class II, receiving treatment with diuretic, digitalis, beta-blockers and angiotensin-converting enzyme (ACE) inhibitor. Conclusion: This is a very interesting case of an adult in the third decade of life with cc-TGA associated with abnormalities not described in the literature that had reached adulthood. Noninvasive images play an important role in its diagnosis.
文摘Rationale: Pompholyx refers to pruritic vesicles or bullous rash that mainly distribute on the palms and lateral surfaces of the fingers. It is less common among Asians, and in a severe condition, secondary bacterial infection of pompholyx can happen and result in pain, swelling and pustules.Patient concerns: A 15-year-old girl complained of progressive wound and small bumps containing yellowish pus and crusts on her hands and feet for over 6 months and worsened in the last month before admission. She also had Ebstein anomaly.Diagnosis: Atypical pompholyx with secondary Staphylococcus and Klebsiella infections. Interventions: Wound care with wet dressing and applying moisturizer on crusts, application of antibiotics for Gram positive and negative bacteria and giving nutritional support with reckoning of proper calories. Outcomes: Skin lesions were completely healed and the patient was discharged after 10 days of hospitalization.Lessons: Atypical manifestation of pompholyx makes it hard to diagnose. The diagnosis can be confirmed with meticulous historytaking and physical examination. Wound caring and controlling of the infection should be done to earn an optimal outcome.
文摘Ebstein’s anomaly is a rare congenital heart disease. We report a series of 4 cases of Ebstein’s anomaly discovered in adolescents. The mean age was 13.75 ± 0.96, with 3 boys and one girl. Three were in heart failure. The EKG showed atrial hypertrophy (1 case), right bundle branch block (1 case), Wolff-Parkinson-White (1 case), and atrial fibrillation (1 case). Cardiomegaly was present in all patients with a mean cardiothoracic index of 0.77 ± 0.03. On echocardiography, the mean apical displacement of the tricuspid septal leaflet was 22.5 ± 3.30 mm/m<sup>2</sup>, the Celermajer index was Grade 2 in 2 patients and Grade 4 in 2 patients. Depletive medical treatment was prescribed to 3 patients. Anticoagulant therapy was initiated in one patient. Two are awaiting surgery. One death was recorded, it was at Grade 4 of the Celermajer index.
文摘Main pulmonary artery aneurysms are rare,mostly asymptomatic and discovered accidentally.The main pulmonary artery aneurysms may be idiopathic or secondary to underlying diseases such as pulmonary hypertension,Behcet’s disease,connective tissue disorders,congenital heart disease,vasculitis,syphilis,tuberculosis and endocarditis.There are some indices that dextrocardia is associated with anomalies of the pulmonary arteries and pulmonary valve.A rare occurrence of main pulmonary artery aneurysms results in a lack of recommendations,so the remaining challenges are whether main pulmonary artery aneurysms should be treated,how,and when.The decision on surgical intervention or conservative treatment of the main pulmonary artery aneurysms depends on its size,etiology and accompanying diseases and includes a multidisciplinary heart team.Our case of the main pulmonary artery aneurysm and pulmonary valve abnormality associated with Ebstein anomaly and dextrocardia in a 67-year-old male patient brings causality considerations and treatment options in such a unique condition.
文摘Ebstein's anomaly(EA) is a rare cardiac congenital malformation with displacement of septal and posterior tricuspid leaflets,resulting in atrialization of the right ventricle.We report a case of EA in which the etiology of a malfunctioning prosthetic tricuspid valve is depicted on cardiac computed tomography to be as a result of thrombus lodged in the valve.
基金地震数值预测联合实验室开放基金项目(2020LNEF03)APSCO Earthquake Research Project PhaseⅡ:Integrating Satellite and Ground Observations for Earthquake Signatures and Precursors(WX0519502)。
文摘针对2013年1月23日辽宁灯塔MS5.1地震,利用引潮力附加构造应力(Additional Tectonic Stress Caused By Tidal Force, ATSCTF)计算模型,计算得到震中位置(41.5°N, 123.2°E)在地震前5周以及震后3周(2012年12月16日—2013年2月15日)的ATSCTF变化。地震发生时,ATSCTF垂直方向分量处于高相位点附近,显示引潮力对本次正断层走滑型地震具有诱发作用。以ATSCTF变化周期的各低相位点时间(2012年12月19日、 2013年1月4日、 2013年1月18日、 2013年2月2日)数据分别为背景,各周期期后数据分别与背景逐日相减,计算研究区(36°N~46°N, 118°E~128°E)范围内,National Oceanic and Atmospheric Administration (NOAA)卫星射出长波辐射数据(Outgoing Long Wave Radiation, OLR)在各ATSCTF周期时段分布及其变化。结果显示,无震的ATSCTF变化的A、 B、 D周期,震中附近OLR无变化;发震的ATSCTF变化的C周期,在空间上,该地区震前OLR仅震中及其南侧区域发生了显著连续升高变化过程,在时间上经历了初始微异常→异常加强→高峰→衰减→发震→平静的演化过程,与岩石应力加载—破裂经历:初始微动破裂→扩张破裂→应力闭锁→地震爆发→平静的力学演化过程中各阶段红外辐射特征一致;显示引潮力对处于临界状态的活动断层具有诱发作用,而OLR是地震构造应力应变过程辐射表征。
文摘Ebstein disease is a rare congenital malformation whose clinical presentation differs according to the anatomical form and age of the patient. In adults, it presents mainly in the form of right or global heart failure or rhythm disorders. Survival is exceptionally long in some forms. We report the case of a 70-year-old patient with Ebstein’s disease in right heart failure.
文摘Among all congenital heart disease,Ebstein anomaly is the lesion with the widest spectrum of presentation.It can present as early as the neonatal period where immediate intervention is often needed to the adult with no discernable symptoms.It is also one where overall outcome greatly relates to age at presentation.Generally,presentation in the neonatal period is associated with poor outcomes while presentation beyond the neonatal period has excellent outcomes with low operative mortality.It is thus apparent that understanding every aspect of the anatomy and physiology of Ebstein anomaly and how it manifests clinically is paramount to successful treatment.The purpose of this review is to outline the current concepts and strategies in the surgical management of Ebstein anomaly,and to discuss the current expert consensus on how best to tackle this congenital heart disease at different ages of diagnosis.
文摘Aim: To present the various echocardiographic spectrum of Ebstein’s mal-formation in adolescence and adults. Introduction: Ebstein’s anomaly has different anatomic and hemodynamic variables with clinical manifestations of cyanosis, right-sided heart failure and arrhythmias. The leaflet tethering and dysplasia, together with dilatation of the tricuspid valve ring, constitute the anatomic cause of tricuspid regurgitation observed in this condition. Case Reports: The spectrum of leaflet tethering from mild to extreme with varying degrees of tricuspid regurgitation were documented by echocardiography in a 16-year-old cyanotic male with Ebstein’s anomaly associated with an atrial septal defect and mild low tricuspid regurgitation (TR), 22-year-old acyanotic male with right-sided heart failure due to severe tricuspid regurgitation and an intact atrial septum, 55-year-old asymptomatic female with moderate high tricuspid regurgitation. The extreme form was described as an “atretic” mem-brane in a 28-year-old cyanotic male and as a “blanket” of leaflet tissue in a 30-year-old cyanotic male. Conclusion: Ebstein’s anomaly has to be sus-pected clinically in presence of cyanosis with a WPW (Wolf-Parkinson-White) or atrioventricular (AV) block pattern of ECG and its management is complex and must be individualized. RV (right ventricular) exclusion procedures are preferred in advanced cases.
