Limits...
Case 2/2015 a 33-year-old woman with double right ventricular chamber and ventricular septal defect.

Atik E - Arq. Bras. Cardiol. (2015)

View Article: PubMed Central - PubMed

Affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

QRSA: -70º, TA: + 30º. showed normal cardiac silhouette (cardiothoracic ratio of0.46)... The pulmonary vascular network was normal and the arch of the pulmonary arterywas concave (Figure 1). (Figure 2) showedright ventricular inflow tract stenosis causing an intraventricular gradient of 80 mmHg,with a 13-mm diameter ventricular septal defect partially occluded by the tricuspidvalve, thus resulting in an effective 4.7‑mm orifice... RV systolic pressure = 110 mmHg. (Figure 2)Pressure values were: RV inflow tract = 98/13; RV outflow tract = 25/7; PT = 20/7-12; LV= 124/11; Ao = 126/64; PC = 11 mmHg... Severe RV inflow tract stenosis with perimembranousventricular septal defect of little impact, with no hypoxemia and/or heart failure, innatural course... The clinical elements of long-standing rightobstructive congenital heart defects without hypoxemia present as shortness of breathand are not accompanied by hematocrit elevation... The severe systolic murmur in themid-left sternal border suggests the presence of an obstructive lesion in the RV inflowtract and differentiates from the murmur of the ventricular septal defect for beingcoarser and stronger... Ventricular septal defects of little impact do not result in anyfunctional disturbance, and their auscultatory manifestation mingles with that of theobstructive defect... Heart diseases with RV outflow tract obstructionmay have a similar presentation, except for the systolic murmur, which is more intensein the upper left sternal border, irradiating to the neck vessels, albeit mildly... Most of thesepatients are treated in childhood and very uncommonly in adulthood... These defects resultfrom an impaired growth of the trabecular myocardium during the early fetal formation,and the non-uniformity in its position, closer to the tricuspid or pulmonary valve,which causes the ventricle to divide into two parts – a proximal and a distal part... Theyare frequently associated with ventricular septal defects (80% of cases)... Even when their impact is minor, these obstructive anomalies should betreated earlier to prevent an unfavorable outcome in relation to the development ofmyocardial fibrosis, arrhythmias and heart failure.

Show MeSH

Related in: MedlinePlus

(A) 4-chamber apical view echocardiogram shows ventricular septal defect withseptal aneurysm (arrow); (B and C) short-axis cross-sectional view showing rightventricular inflow tract stenosis (arrows, in colors). (D) Angiography showingseptal aneurysm (arrow) and (E) right ventricular inflow tract stenosis (arrow)with marked hypertrophy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4375663&req=5

f02: (A) 4-chamber apical view echocardiogram shows ventricular septal defect withseptal aneurysm (arrow); (B and C) short-axis cross-sectional view showing rightventricular inflow tract stenosis (arrows, in colors). (D) Angiography showingseptal aneurysm (arrow) and (E) right ventricular inflow tract stenosis (arrow)with marked hypertrophy.

Mentions: Echocardiogram (Figure 2) showedright ventricular inflow tract stenosis causing an intraventricular gradient of 80 mmHg,with a 13-mm diameter ventricular septal defect partially occluded by the tricuspidvalve, thus resulting in an effective 4.7‑mm orifice. There was RV hypertrophy withmildly enlarged right cardiac chambers. Gradient between ventricles was 82 mmHg. Therewas a small aneurysm formation in the ventricular septum. Measurements were as follows:left ventricle (LV) = 45 mm; left atrium (LA) = 32; Ao = 26; septum = posterior wall = 7mm. LV ejection fraction = 66%. There was a 3-mm foramen ovale with bidirectionalpredominantly left‑to‑right shunt. RV systolic pressure = 110 mmHg.


Case 2/2015 a 33-year-old woman with double right ventricular chamber and ventricular septal defect.

Atik E - Arq. Bras. Cardiol. (2015)

(A) 4-chamber apical view echocardiogram shows ventricular septal defect withseptal aneurysm (arrow); (B and C) short-axis cross-sectional view showing rightventricular inflow tract stenosis (arrows, in colors). (D) Angiography showingseptal aneurysm (arrow) and (E) right ventricular inflow tract stenosis (arrow)with marked hypertrophy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4375663&req=5

f02: (A) 4-chamber apical view echocardiogram shows ventricular septal defect withseptal aneurysm (arrow); (B and C) short-axis cross-sectional view showing rightventricular inflow tract stenosis (arrows, in colors). (D) Angiography showingseptal aneurysm (arrow) and (E) right ventricular inflow tract stenosis (arrow)with marked hypertrophy.
Mentions: Echocardiogram (Figure 2) showedright ventricular inflow tract stenosis causing an intraventricular gradient of 80 mmHg,with a 13-mm diameter ventricular septal defect partially occluded by the tricuspidvalve, thus resulting in an effective 4.7‑mm orifice. There was RV hypertrophy withmildly enlarged right cardiac chambers. Gradient between ventricles was 82 mmHg. Therewas a small aneurysm formation in the ventricular septum. Measurements were as follows:left ventricle (LV) = 45 mm; left atrium (LA) = 32; Ao = 26; septum = posterior wall = 7mm. LV ejection fraction = 66%. There was a 3-mm foramen ovale with bidirectionalpredominantly left‑to‑right shunt. RV systolic pressure = 110 mmHg.

View Article: PubMed Central - PubMed

Affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

QRSA: -70º, TA: + 30º. showed normal cardiac silhouette (cardiothoracic ratio of0.46)... The pulmonary vascular network was normal and the arch of the pulmonary arterywas concave (Figure 1). (Figure 2) showedright ventricular inflow tract stenosis causing an intraventricular gradient of 80 mmHg,with a 13-mm diameter ventricular septal defect partially occluded by the tricuspidvalve, thus resulting in an effective 4.7‑mm orifice... RV systolic pressure = 110 mmHg. (Figure 2)Pressure values were: RV inflow tract = 98/13; RV outflow tract = 25/7; PT = 20/7-12; LV= 124/11; Ao = 126/64; PC = 11 mmHg... Severe RV inflow tract stenosis with perimembranousventricular septal defect of little impact, with no hypoxemia and/or heart failure, innatural course... The clinical elements of long-standing rightobstructive congenital heart defects without hypoxemia present as shortness of breathand are not accompanied by hematocrit elevation... The severe systolic murmur in themid-left sternal border suggests the presence of an obstructive lesion in the RV inflowtract and differentiates from the murmur of the ventricular septal defect for beingcoarser and stronger... Ventricular septal defects of little impact do not result in anyfunctional disturbance, and their auscultatory manifestation mingles with that of theobstructive defect... Heart diseases with RV outflow tract obstructionmay have a similar presentation, except for the systolic murmur, which is more intensein the upper left sternal border, irradiating to the neck vessels, albeit mildly... Most of thesepatients are treated in childhood and very uncommonly in adulthood... These defects resultfrom an impaired growth of the trabecular myocardium during the early fetal formation,and the non-uniformity in its position, closer to the tricuspid or pulmonary valve,which causes the ventricle to divide into two parts – a proximal and a distal part... Theyare frequently associated with ventricular septal defects (80% of cases)... Even when their impact is minor, these obstructive anomalies should betreated earlier to prevent an unfavorable outcome in relation to the development ofmyocardial fibrosis, arrhythmias and heart failure.

Show MeSH
Related in: MedlinePlus