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   2014| July-September  | Volume 24 | Issue 3  
    Online since November 5, 2014

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Left Atrium: Still a neglected chamber?
Maria Chiara Todaro, Bijoy K Khandheria
July-September 2014, 24(3):72-77
It is widely recognized that an effective cardiovascular system is based upon both a good ventricular-vascular interplay and a good ventricular-atrial interaction in all the phases of cardiac cycle. Moreover, left atrial dysfunction has been identified to be contributory in several common cardiovascular conditions, such as heart failure, atrial fibrillation and valvular heart disease; for instance, a good anatomical and functional assessment of this cardiac chamber is mandatory. For this purpose a multimodality imaging approach - including two-dimensional and three-dimensional echocardiography, speckle tracking technique, cardiac computed tomography (CT) and cardiac magnetic resonance (CMR) - is the most suitable one to achieve the best functional and anatomical evaluation of this cardiac chamber.
  3,914 218 1
Chronic stress and early recurrence of takotsubo cardiomyopathy: A clinical case
Giuseppina Novo, Patrizia Carita, Laura Ajello, Pasquale Assennato
July-September 2014, 24(3):83-85
Takotsubo cardiomyopathy (TC) is characterized by transient systolic dysfunction of the apical and middle segments of the left ventricle, accompanied by electrocardiographic abnormalities and mild elevation of cardiac biomarker levels in the absence of obstructive coronary artery disease. The following case is of a woman suffering from chronic emotional stress with a very early recurrence. An acute trigger event was not detectable in both cases. It is possible to suppose that, in predisposed subjects, chronic stress by increasing sympathetic activity may be considered not only a trigger for TC, but also a negative prognostic factor for early recurrence.
  2,896 79 2
Role of cardiovascular ultrasound in the evaluation of obese subjects
Francesco Antonini-Canterin, Marco Pellegrinet, Ricarda Marinigh, Giuseppe Favretto
July-September 2014, 24(3):67-71
Obesity represents a worldwide increasing health problem. Obesity, through complex and not fully understood pathogenetic mechanisms, induces different structural and functional changes of left heart chambers, right heart chambers, and arteries. Ultrasound techniques are the first choice for a comprehensive assessment of the cardiovascular adaptation to obesity. This review summarizes the up-to-date literature on the topic, with particular focus on the main clinical studies, which range over different cardiovascular adaptations to obesity, namely left ventricular mass, diastolic function, right ventricle structure and function, arterial stiffness, and intima-media thickness. Also, the importance of epicardial fat and of the degree of obesity is described. Finally, the role of weight loss and bariatric surgery and the study of cardiovascular obesity-induced abnormalities in children and adolescent are discussed.
  2,650 147 1
Extension to the heart of metastatic lung cancer presenting as acute neurological syndrome: The key role of echocardiography
Gabriella Falanga, Olimpia Musumeci, Cesare Stilo, Concetta Zito
July-September 2014, 24(3):89-91
Metastatic cardiac malignancies are significantly more common than primary cardiac tumors. Primary lung cancers often invade the heart locally and they can also spread to the heart via the blood, lymphatic system or both; in contrast, an extension to the left atrium from the pulmonary vein is very rare. Here, we report a case of a 79-year-old man with an acute neurological syndrome, in which an integrated multimodality imaging approach has allowed to discovery a lung cancer with cerebral embolism and intracavitary heart dissemination through the left superior pulmonary vein.
  2,682 89 -
Infective endocarditis complicated with anterior mitral leaflet abscess: A case report
Sushama Krishnat Jotkar, Gayatri Gurudas Harshe, Vivek B Chavan
July-September 2014, 24(3):92-94
Infective endocarditis (IE) is defined as infection of endocardial surface of the heart. It may include one or more heart valves, the mural endocardium or a septal defect. Its intracardiac effect includes severe valvular insufficiency which may lead to intractable congestive heart failure and myocardial abscess. Infective endocarditis especially complicated by an abscess is associated with high mortality, despite the medical and surgical therapeutic options available. Surgical intervention is indicated in cases of heart failure or uncontrolled infection and sometimes for the prevention of embolic phenomena. We report a case of 42 yrs/M with RVHD admitted in Dr D.Y.Patil hospital, Kolhapur. He had high grade, continuous fever, vomiting, cough with expectoration since 15 days prior to admission. He had prior embolic stroke 2 months back from which he recovered completely. The diagnosis of Infective endocarditis was confirmed clinically & echocardiographically by Duke's criteria. His ECHO showed severe MR, Moderate MS and large vegetations on AML oscillating through mitral orifice along with subvalval (mitral) abscess. Due to severe haematemesis following Mallory weiss tear surgical intervention was not possible. Patient succumbed as a result of refractory pulmonary oedema.
  2,545 126 1
Tumor plop in a febrile child: Unusual presentation of tricuspid valve endocarditis
Anshuman Darbari, Devender Singh
July-September 2014, 24(3):86-88
Tricuspid valve endocarditis in a structurally normal heart of child is extremely rare and mysterious disease, which may mimic several other illnesses. We are reporting here a six-year-old child who presented with prolonged fever and unusual auscultatory sound of tumor plop, later proven to having tricuspid valve endocarditis by 2D echocardiography. The patient underwent surgical excision of the vegetations with repair of the tricuspid valve leaflets with successful outcome.
  2,475 79 -
An unusual left ventricular apical mass
Erika Cavallero, Mirko Curzi, Sara Anna Cioccarelli, Giulio Papalia, Diego Ornaghi, Renato Maria Bragato
July-September 2014, 24(3):95-96
Left ventricular apical masses constitute a rare finding. Imaging properties together with the clinical history of the patient usually allow an etiologic definition. We report a challenging case of an ambiguous left ventricular apical mass of uncertain nature till histological examination. Points of interest were singular clinical history and echocardiographic findings, although not conclusive in hypothesis generating. Furthermore to the best of our knowledge, this is one of the rare attempt to excise a deep left ventricular mass with a mini-invasive surgical approach.
  2,309 109 -
Association of corrected QT and QT dispersion with echocardiographic and laboratory findings in uremic patients under chronic hemodialysis
Arsalan Khaledifar, Ali Momeni, Katayoun Hasanzadeh, Masoud Amiri, Morteza Sedehi
July-September 2014, 24(3):78-82
Introduction: Cardiovascular disease is the most common cause of mortality in dialysis patients. Chronic renal failure and hemodialysis (HD) patients may have longer corrected QT (QTc) interval compared with the normal population. Long QTc interval may be a predictor of ventricular arrhythmia and cardiovascular mortality in these patients and hence the aim of this study was the evaluation of the relationship between QTc interval and some echocardiographic findings and laboratory exam results in HD patients. Materials and Methods: In a cross-sectional study, 60 HD patients with age >18 years and the dialysis duration >3 months were enrolled. Blood samples were taken, and electrocardiography and echocardiography were done before the dialysis session in the patients. Results: Mean age of the patients was 56.15 ± 14.6 years. QTc interval of the patients was 0.441 ± 0.056 s and QT dispersion (QTd) was 64.17 ± 25.93 ms. There was no statistically significant relationship between QTc interval and QTd with duration of dialysis, body mass index, age, and gender (P > 0.05). There was also no significant relationship between QTc interval and QTd with mitral regurgitation, tricuspid regurgitation and aortic insufficiency (P > 0.05). In addition, QTc interval and QTd of the patients had not any correlation with serum parathormon and serum Ca, K, HCO 3 (P > 0.05). Conclusion: Based on our results, in HD patients, QTc interval and QTd were not correlated with echocardiographic findings or laboratory exam results. Therefore, it can be concluded that QTc interval prolongation probably has not any correlation with cardiac mortality of the HD patients.
  2,288 118 -