Biomedical subjects

M Rusznák

Publications and source records attributed to M Rusznák.

At least 19 recordsLinked to original sources

PubMed1998

[Incidence of septal aneurysm and its clinical significance].

The authors performed 451 transesophageal echocardiographic (TEE) investigations over a period of three years and four months. Atrial septal aneurysm (ASA) was found in 40 cases. Of these, protrusion of the atrial septum towards the right atrium was observed in 17 cases, whilst oscillation of the atrial septum was noted in 23 cases. ASA was associated with patent foramen ovale (PFO) in ten patients, with type II. ASD in nine patients, with other congenital heart disease in six patients, and with other organic heart disease in eight patients. In three cases either an embolus or a tumor was detected in the left atrium, whilst in four cases with ASA there were no other organic cardiac disorders found. In ten patients there was a history of cerebral embolisation. Of these two had chronic atrial fibrillation, whilst the others had sinusrhythm. Of those who had cerebral embolisation, four patients had PFO, one patient had left atrial and auricular thrombi, whilst in four patients various organic heart problems (ischemic heart disease, left ventricular hypertrophy) were detected. In one patient with ASA there was no other cardiac abnormality detected. The authors conclude that ASA, which is often associated with PFO and ASD (in 25.0% and 22.5% of their cases, respectively) is detected in around eight percent of the patients who undergo TEE. ASA particularly when associated with PFO should be considered as a potential source of cerebral emboli. Indeed, cerebral embolisation occurred in 25% of their patients with ASA. It is recommended, that patients with ASA are treated with acetyl salicylic acid, whilst in patients with ASA and PFO anticoagulant therapy is the treatment of choice. In case of cerebral embolisation, or repeated cerebral ischemic attacks, operative interventions should be considered.

Echocardiography, Transesophageal↗

PubMed1996

[The frequency of left atrial spontaneous echo contrast and its clinical significance in mitral valve insufficiency].

The authors investigated the frequency of left atrial spontaneous echo contrast in mitral valve disease. They also tested whether there was any correlation between the presence of left atrial spontaneous echo contrast and the severity of the mitral valve disease. Echocardiographic investigations were performed using both transthoracal and transesophageal echocardiographic methods employing monoplane transducer. The authors carried out 273 transesophageal investigations over a period of 2 years and found left atrial spontaneous echo contrast in 85 patients, who had mitral valve disease. Of this, in 18 cases thrombi were also detected in the left atrium and/or auricula. The diagnoses of mitral stenosis were made in 24 patients, of whom in 12 cases the stenosis were found to be severe, whilst in 12 cases to be moderate. Furthermore insufficiency of the mitral valve was detected in 35 cases. 20 patients had artificial mitral valve implanted, they received long term anticoagulant treatment. 59 patients had no spontaneous echo contrast. 14 patients had previous embolic events of which 9 were cerebral and in other cases arteries of the kidney, eye and extremities were affected. 71 patients had no history of embolism. The authors concluded that mitral valve disease, particularly mitral stenosis is frequently associated with left atrial spontaneous echo contrast. It has been also observed, that the more severe the mitral valve disease, the greater the probability of left atrial spontaneous echo contrast. In all cases where thrombi were found, left atrial echo contrast were demonstrated and the risk of embolism is high. In these cases anticoagulant therapy is suggested.

Adolescent↗

PubMed1993

[Obstructive cardiomyopathy, caused by amyloidosis, associated with bone marrow myeloma].

A case of a 40-year-old female is reported. Her symptoms started with abdominal complaints, loss of weight, general weakness, then gradually polyneuropathy, worsening hypotonia and systolic heart murmur developed. The bone marrow showed 20-25% infiltration by myeloma. An IgG lambda type paraproteinaemia was diagnosed using immunelectrophoresis. The ejection systolic murmur was caused by restrictive cardiomyopathy--characteristic of primary amyloidosis--with obstruction of the outflow tract of the left ventricle. Echocardiographic changes took 11 months to develop. The patient's status became dominated by severe hypotonia and she died as a result of heart failure. The post mortem examination confirmed amyloidosis with myeloma. Histopathological examination of the myocardium, coronary and other arteries revealed severe changes with AL-type amyloid deposits. The case demonstrates that amyloidosis can lead not only to restrictive cardiomyopathy but obstruction of the outflow tract of the left ventricle.

Adult↗

PubMed1993

[Echocardiographic detection and follow up of left ventricular thrombosis following myocardial infarct].

914 patients with myocardial infarction have been examined during the last 3 years. Left ventricular thrombi were found in 74 patients (8%), (58 male and 16 female, median age 57.3 years). Thrombi were found in 37 cases, oval protruding in 28 cases, pedicled or multiple in 9 cases. Thrombus was most frequently located to the apex (61 cases), while in 8 patients localization was anteroseptal, in 4 patients anterolateral and in 1 patient inferior. 36 patients had also ventricular aneurysm of which 23 were at the apex and 13 at the anterior wall. After anticoagulant therapy the patients were controlled by echocardiography. In 23 out of the 53 patients that were restudied the thrombus had resolved, in 8 patients thrombus has decreased in size and in 22 patients there was no change in thrombus size. Embolism has occurred in 13 cases of which 10 were cerebral embolism. During the follow-up period (mean 12.8 months) six patients died. On the basis of their study the authors conclude that thrombosis is a frequent complication of anterior myocardial infarction and may lead to embolic events, so anticoagulant therapy controlled by echocardiography is needed, because of it's efficacy in the resolution of thrombus and eliminating the risk of embolism.

Adult↗

PubMed1992

[Doppler echocardiography in the evaluation of left ventricular diastolic function in hypertension].

Twenty-five hypertensive patients were examined using Doppler echocardiography to determine the diastolic function of the left ventricle. Twenty-two parameters were analysed and the diastolic indexes were compared with the results of a control group of ten healthy volunteers. Patients with hypertension showed significant left ventricular hypertrophy with increased left ventricular mass and dilated left atrium. Eighty-five percent of the hypertensive patients were found to have impaired diastolic function. The peak velocity of the early, and late diastolic phase and also the duration of acceleration and deceleration are considered to be necessary in the investigation of the diastolic function of left ventricle. All the other parameters can be determined using the above mentioned ones. The late diastolic transmitral flow, the atrial filling velocity, the time of deceleration and acceleration and also the time velocity integral increased significantly. However, the early diastolic filling fraction decreased significantly. The abnormalities in left ventricular diastolic function and also the atrial enlargement may be the early signs of hypertensive heart disease and therefore have a great importance in the therapy.

Diastole↗

PubMed1991

[Experience in the care of patients with artificial heart valves].

Author reports of 164 cases, 145 of whom received mechanic artificial valves and 19 bioprosthesis. 76 valves were implanted in mitral position, 65 in aorta position, 19 in mitral and aorta position, and 4 valves were localized in other positions. Follow-up was 5.9 years meanly. During care paravalvular insufficiency (11 cases) and infectious endocarditis (9 cases) were observed most frequently. Thromboembolic complications developed in 6 patients, artificial-valve-thrombosis and severe haemorrhage occurred in four cases respectively. During care 32 patients died. This is a 5.4 p.c. mortality. The most frequent causes of death were left-ventricle insufficiency (10) and infectious endocarditis (8). Artificial valve thrombosis and subdural haemorrhage lead to death in three cases respectively. Author discusses anticoagulant treatment and emphasizes the importance of regular control to avoid complications and to discover them at an early stage.

Aortic Valve↗

PubMed1987