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Biomedical subjects

N C Nanda

Publications and source records attributed to N C Nanda.

At least 199 records · Page 11Linked to original sources
PubMed1979

Surgical management of an aneurysm of the left main coronary artery.

A 28-year-old woman underwent cardiac catheterization three months after sustaining an acute anterolateral myocardial infarct. An aneurysm of the left main coronary artery was found at angiography and also was visualized by two-dimensional echocardiography. The patient had no evidence of atherosclerotic vascular disease. At operation, vein grafts were placed to bypass the aneurysm and the orifice of the left coronary artery was oversewn to exclude the aneurysm from the coronary circulation.

Adult↗
PubMed1979

New techniques in cardiac imaging with ultrasound: state of the art.

Two-dimensional real-time ultrasonic imaging in the diagnosis of acquired and congenital cardiac lesions is reviewed. This technique provides anatomically correct cross-sectional images and demonstrates movements of valve leaflets and segments of heart walls. The imaging of blood flow through the use of ultrasonic contrast agents and the application of pulsed Doppler principles is also reviewed, and future trends are discussed.

Contrast Media↗
PubMed1979

Familial cardiac myxoma: emphasis on unusual clinical manifestations.

This report describes familial cardiac myxoma involving parent and child. The familial occurrence of this condition, previously reported in four other families, underscores the necessity of screening all direct members of the family by echocardiography once the diagnosis of cardiac myxoma is made. Each patient presented with unusual clinical manifestations. The father, who had a right atrial myxoma associated with an atrial septal defect and mitral valve prolapse, presented with findings highly suggestive of paradoxical embolism. The daughter, who had an infected right ventricular myxoma, was initially treated for valvular subacute bacterial endocarditis before the diagnosis was made.

Adult↗
PubMed1978

Systolic flutter of the mitral valve.

Systolic flutter of the mitral valve was observed in 11 cases during the past 3-1/2 years. All patients had mitral regurgitation due to mitral valve prolapse or flail leaflets, and nine of the 11 (82%) had prior or concurrent bacterial endocarditis. Systolic flutter is uncommon in the absence of endocarditis and was observed in only two of 15 patients (13%) with proven chordae tendinae or papillary muscle rupture without historical and pathological evidence of infection involving the mitral valve. Systolic flutter was also not seen in a large number of patients with mitral regurgitation due to other causes. It is postulated that the regurgitation jet of blood across the edge of a structurally abnormal but flexible mitral leaflet is important for the development of flutter.

Aged↗
PubMed1978

Bilateral atrial myxomas. Echocardiographic considerations.

In this report we describe a patient with bilateral atrial myxomas, which were diagnosed preoperatively by echocardiography and angiography, and successfully removed. The excised tumor mass consisted of mobile right and left atrial myxomas connected by a common stalk which passed through the atrial septum, collectively resembling the shape of a dumbbell. Preoperative echocardiographic and angiographic observations were instrumental in planning the surgical approach, and correlated well with intraoperative findings and with the anatomic configuration of the intact pathologic specimen. Diagnostic aspects of echocardiography are emphasized as they relate to both isolated and bilaterally-occurring atrial myxomas.

Adult↗
PubMed1978

The relationship between aortic valve closure and aortic root motion.

The minimum interval between aortic valve closure and the onset of posterior motion of the posterior aortic wall (C--PW) was obtained from M-mode echographic studies in normal subjects and patients with mitral regurgitation (MR), rheumatic mitral stenosis (MS), mixed rheumatic MS and MR, pure aortic stenosis (AS), and pure aortic insufficiency. Three-fourths of the patients with MR and 2/3 of those with AS had short C--PW intervals. Short C--PW intervals are probably the result of early mitral valve opening with rapid LA emptying, whereas slow emptying due to dilated, relatively inert left atria may account for normal C--PW intervals in patients with MR. C--PW intervals are affected by both ventricular ejection and LA dynamics and may prove useful in evaluating suspected mitral or aortic valve disease.

Adolescent↗
PubMed1978

Echocardiographic evaluation of intracardiac pacing catheters: M-mode and two-dimensional studies.

Thirty patients with right ventricular (RV) and 15 with coronary sinus (CS) pacing catheters were studied by M-mode echocardiography. RV catheters, detected in 23, appeared as linear echoes in the right ventricle during mitral valve recordings in 12, adjacent or superimposed on the tricuspid valve (TV) in 14, and immediately anterior to aortic root and pulmonary valve echoes in two with a redundant loop in RV outflow. In three with complete heart block, prominent systolic anterior movements of the TV occurred when atrial systole coincided with ventricular systole, probably due to catheter-induced TV "buckling" or exaggerated TV annular motion. Catheter echoes mimicked TV recordings in three, since its motion pattern was similar, although delayed and mimicked prolapsing right atrial myxomas in two because of multilayered complexes behind TV, while reverberations cluttering the left ventricle simulated structural echoes present in that cavity. CS catheters, detected in 14 as linear echoes in the area of atrial septum recorded behind the TV, showed typical small humps in late diastole/early systole. Cross-sectional echocardiography with a mechanical sector scanner demonstrated RV catheters at the RV apex in five of seven patients, while CS catheters were detected near the base of the atrial septum in three of five patients. Echocardiography has the potential to localize pacing catheters which are occasionally difficult radiologically or electrocardiographically. Failure to recognize catheter echo patterns may result in errors in echocardiographic interpretation.

Cardiac Pacing, Artificial↗
PubMed1977

Echocardiography of the aortic root.

The anterior and posterior walls of the aortic root are recognized as a pair of parallel linear signals which move anteriorly in systole and posteriorly in diastole. Valve cusps appear as thin lines which move briskly toward the periphery of the aortic lumen in systole and coapt in the middle in diastole producing a box-like configuration. Cusp calcification results in the appearance of multiple, linear echoes within the aortic root. Mild aortic stenosis is characterized by lightly calcified leaflets whereas heavy calcification, which completely obscures cusp motion, signifies severe stenosis. Aortic aneurysms produce significant enlargement of the aortic root image; marked widening of the aortic walls indicates the presence of aortic root dissection, but there are important limitations and pitfalls in the diagnosis of this condition. A markedly eccentric diastolic cusp position within the aortic lumen resulting in asymmetric images of the leaflets in systole is the hallmark of a bicuspid aortic valve. An abrupt premature closure of the valve leaflets in early systole is typical of subaortic membranous stenosis. In tetralogy of Fallot the aortic root is dilated and overrides the ventricular septum.

Aortic Dissection↗
PubMed1977

The reliability of echocardiography in the diagnosis of infective endocarditis.

The echocardiograms of 17 patients with proved infective endocarditis were surveyed to assess the reliability of echocardiography in this disease. Vegetations were present on 20 valves (11 aortic, 7 mitral, 2 tricuspid) at surgery or autopsy. Echocardiography correctly identified the abnormality in 11 valves. There were 8 valves with false-negative studies of which only one examination was technically inadequate. One false-positive echocardiogram was found. A negative echocardiogram does not exclude infective endocarditis. The size of the vegetation is not the only consideration in its detection echocardiographically. False-positive and false negative studies are discussed.

Adolescent↗
PubMed1977

Echocardiographic features of combined membranous subaortic stenosis and acquired calcific aortic valvulopathy.

The M-mode echocardiographic features of aortic valve structure and motion in a 45-year-old male with combined congenital subaortic diaphragm and acquired deformity of the aortic valve are described. Clinical, hemodynamic, and angiographic studies suggested calcific aortic valve disease with stenosis and insufficiency, but the additional presence of a subaortic diaphragm was not appreciated. Cardiac ultrasonography demonstrated multiple, central diastolic aortic valve cusp echoes consistent with a thickened, calcified, tricuspid aortic valve. Despite calcification of the cusps, however, enough systolic cusp excursion remained to demonstrate an early systolic, rapid movement toward closure of the right coronary cusp-a finding suggestive of fixed subvalvular obstruction. Surgery confirmed a discrete subaortic diaphragm and a tricuspid, thichened, mildly calcified aortic valve with fusion of the cusp commissures at their origins and rolling back of the cusp edges. The value of echocardiography in the evaluation of the left ventricular outflow tract and aortic valve is emphasized.

Aortic Valve↗
PubMed1976

Echocardiographic study of the effects of acute left atrial hypertension on left atrial size.

This study was designed to investigate the effects of acute left atrial hypertension on left atrial size. Twenty-four patients with acute myocardial infarction were studied. The estimated mean left atrial pressure (LAm) was correlated with left atrial (LA) size obtained by echocardiogrphy. The LAm was elevated (greater than 12 mmHg) in 15 patients (Group I). The LA size was within normal limits in all but two patients who had minor increases. The LAm was normal in nine patients (Group II). The LA size was normal in each case. The LA size remained unchanged in those patients who had a stable LAm. We conclude that acute increases in LAm are not usually associated with LA enlargement beyond the upper limit of the normal range.

Blood Pressure↗
PubMed1976

Echocardiographic studies of abnormalities associated with coarctation of the aorta.

Echocardiograms were performed in thirty-six patients (aged 4 to 36 years) with proven coarctation of the aorta. Nineteen patients (53%) were found to have marked diastolic eccentricities of their aortic valves (Eccentricity Index greater 1.5), indicating the presence of bicuspid aortic valves. One of these patients also had multilayered aortic root echoes in diastole. Five patients had angiographic proof of their aortic valve morphologies which corroborated the echo findings. Five patients with bicuspid aortic valves showed mitral valve diastolic flutter indicative of aortic regurgitation. Idiopathic hypertrophic subaortic stenosis (IHSS) was suspected in four patients (11%) with abnormal systolic anterior motion of the mitral valve; three of these patients also had asymmetric septal hypertrophy. There was catheterization proof of IHSS in one patient. Two patients (5.6%) demonstrated mitral valve proplapse.

Amyl Nitrite↗
PubMed1976

Echocardiography of cardiac valves in pericardial effusion.

Nine adult patients with large pericardial effusions (PE) demonstrated echocardiographic motion abnormalites of cardiac valves in systole. In four cases (Group 1), the abnormal findings consisted of prominent systolic anterior movements of the mitral valve resembling those seen in idiopathic hypertrophic subaortic stenosis. In Group 2(five cases), typical mitral valve prolapse patterns with large posterior midsystolic displacements well below the C point were observed. Additional abnormalities in Group 2 included tricuspid valve prolapse patterns (four cases), early systolic movement of the aortic valve toward closure (three cases), midsystolic notching of the pulmonary valve (two cases) and abnormal or attenuated motion of the aortic root in all patients. Marked decrease or resolution of PE resulted in complete disappearance of all the observed abnormalities. These findings appeared to be related to large fluid collections behind the left atrium and abnormal movement of the heart in the pericardial space. In the presence of PE, therefore, the echocardiographic observation of abnormal valve motion may not be clinically significant.

Adult↗
PubMed1976

Familial mitral valve prolapse and myotonic dystrophy.

When a patient with mitral valve prolapse was found to have myotonic dystrophy, his family was studied to ascertain the occurrence of these abnormalities. Of 25 relatives screened, 8 had evidence of both myotonic dystrophy and mitral valve prolapse and 2 had evidence of myotonic dystrophy alone. Thirteen patients had evidence of neither condition and 1 had mitral valve prolapse alone. The association of these two conditions within a family has not previously been observed and valvular heart disease has not been recognized in myotonic dystrophy. This association should be looked for in other patients.

Adolescent↗