The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional...The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional testing of the heart and lungs. A diagnosis of diastolic heart failure is inferred through the exclusion of systolic abnormalities, a normal pulmonary function test and normal hemoglobin, coupled with diastolic abnormalities on echocardiography. Differentiating confounders such as obesity or deconditioning in a patient with diastolic abnormalities is difficult. While the most recent guidelines provide more avenues for diagnosis, such as incorporating the left atrial size, little emphasis is given to understanding left atrial function, which contributes to at least 25% of diastolic left ventricular filling; additionally, exercise stress testing to elicit symptoms and test the dynamics of diastolic parameters, especially when access to the "gold standard" invasive tests is lacking, presents clinical translational gaps. It is thus important in diastolic heart failure work up to understand left atrial mechanics and the role of exercise testing to build a comprehensive argument for the diagnosis of diastolic heart failure in a patient presenting with SOB.展开更多
Dystrophic cardiac calcification is often associated with conditions causing systemic inflammation and when present,is usually extensive,often encompassing multiple cardiac chambers and valves.We present an unusual ca...Dystrophic cardiac calcification is often associated with conditions causing systemic inflammation and when present,is usually extensive,often encompassing multiple cardiac chambers and valves.We present an unusual case of dystrophic left atrial calcification in the setting of end stage renal disease on hemodialysis diagnosed by echocardiography and computed tomography.Significant calcium deposition is confined within the walls of the left atrium with no involvement of the mitral valve,and no hemodynamic effects.展开更多
Myxoma is a benign and the most frequent tumor of the heart, accounting for approximately 30% of all primary cardiac tumors. Seventy five percent of atrial myxomas are in the left atrium. We present a case of a 20-yea...Myxoma is a benign and the most frequent tumor of the heart, accounting for approximately 30% of all primary cardiac tumors. Seventy five percent of atrial myxomas are in the left atrium. We present a case of a 20-year-old house wife presenting with biventricular heart failure and chest infection five months after her last child birth. Transthoracic echocardiography showed a mobile left atrial echogenic mass measuring 4.6 × 4.0 cm attached to the interatrial septum. Left ventricular systolic function was mildly reduced (EF 48%) with mitral and tricuspid incompetence. A diagnosis of left atrial myxoma with biventricular heart failure with chest infection was made. She improved on antibiotics and treatment of heart failure, and referred to Aminu Kano Teaching Hospital for further management.展开更多
文摘The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional testing of the heart and lungs. A diagnosis of diastolic heart failure is inferred through the exclusion of systolic abnormalities, a normal pulmonary function test and normal hemoglobin, coupled with diastolic abnormalities on echocardiography. Differentiating confounders such as obesity or deconditioning in a patient with diastolic abnormalities is difficult. While the most recent guidelines provide more avenues for diagnosis, such as incorporating the left atrial size, little emphasis is given to understanding left atrial function, which contributes to at least 25% of diastolic left ventricular filling; additionally, exercise stress testing to elicit symptoms and test the dynamics of diastolic parameters, especially when access to the "gold standard" invasive tests is lacking, presents clinical translational gaps. It is thus important in diastolic heart failure work up to understand left atrial mechanics and the role of exercise testing to build a comprehensive argument for the diagnosis of diastolic heart failure in a patient presenting with SOB.
基金Supported by the "East Carolina Heart Institute"
文摘Dystrophic cardiac calcification is often associated with conditions causing systemic inflammation and when present,is usually extensive,often encompassing multiple cardiac chambers and valves.We present an unusual case of dystrophic left atrial calcification in the setting of end stage renal disease on hemodialysis diagnosed by echocardiography and computed tomography.Significant calcium deposition is confined within the walls of the left atrium with no involvement of the mitral valve,and no hemodynamic effects.
文摘Myxoma is a benign and the most frequent tumor of the heart, accounting for approximately 30% of all primary cardiac tumors. Seventy five percent of atrial myxomas are in the left atrium. We present a case of a 20-year-old house wife presenting with biventricular heart failure and chest infection five months after her last child birth. Transthoracic echocardiography showed a mobile left atrial echogenic mass measuring 4.6 × 4.0 cm attached to the interatrial septum. Left ventricular systolic function was mildly reduced (EF 48%) with mitral and tricuspid incompetence. A diagnosis of left atrial myxoma with biventricular heart failure with chest infection was made. She improved on antibiotics and treatment of heart failure, and referred to Aminu Kano Teaching Hospital for further management.
