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PubMedDate not supplied

Correlation of cardiac enlargement as assessed by vertebral heart size and echocardiographic and electrocardiographic findings in dogs with evolving cardiomegaly due to rapid ventricular pacing.

Vertebral heart size (VHS) has been proposed as a method for quantifying cardiomegaly in dogs. This study was designed to determine how well echocardiographic and electrocardiographic findings correlated with VHS. Dogs were rapid-paced into varying degrees of cardiomegaly and were monitored by thoracic radiography, echocardiography, and electrocardiography during development of cardiomegaly. Echocardiographic and electrocardiographic parameters were compared with VHS. VHS increased with increased duration or rate of pacing or both, and left atrium-to-aorta ratio, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, P wave duration, and QRS duration correlated significantly with VHS. VHS (a score obtained from routine thoracic radiographs) seems to correlate well with both echocardiographic and electrocardiographic parameters. When 9 veterinarians, experienced in interpretation of cardiac silhouettes on radiographs, measured VHS from 1 normal dog and 1 dog with severe cardiomegaly, coefficients of variation (ratio of standard deviation to the mean) for their measurements were 2.7% and 2.8%, respectively. Thus, VHS could be established with great uniformity by experienced interpreters.

Animals↗
PubMedDate not supplied

[Correlation between chest radiography and the echocardiogram to evaluate cardiomegaly in patients with systemic arterial hypertension].

UNLABELLED: The chest radiography is used routinely by the clinician as a tool in the scan of patients with systemic arterial hypertension (SAH) to evaluate the dimensions of the heart. However the highest reported sensitivity for the evaluation of heart growth with this method is 77.3% in contrast to the transthoracic echocardiogram (TTE) that reaches between 90 to 100%. The aim of this study was assess in our population of patients with SAH, the correlation between chest radiography and the TTE in regard to cardiomegaly. PATIENTS AND METHODS: Seventy two patients with SAH and radiological cardiomegaly, graded by measuring the cardiothoracic ratio (CTR), were evaluated by transthoracic echocardiography. The Pearson's and Spearman's correlation coefficients between both methods were assessed. Significance level was set at < 0.05. RESULTS: Forty one (56.9%) patients were women and 31 (43.1%) were men. The age was 62.4 +/- 10 years (43-83 years). Left ventricular concentric hypertrophy (LVCH) was found in 56 (77.8%) patients. In 13 (18%) patients the left ventricular end diastolic diameter (LVEDD) was higher than the normal value. The correlation coefficient between the diastolic ventricular septal thickness (DST) and CTR was 0.285 (p < 0.05) and between the LVEDD and radiological cardiomegaly was 0.203 (p = NS). CONCLUSIONS: In patients with SAH, the radiological evidence of cardiomegaly keeps a correlation with ventricular hypertrophy, but not with ventricular dilation.

Adult↗
PubMed1982

Cardiomegaly in hypoglycaemic small-for-gestational-age infants.

The chest X-rays of 15 hypoglycaemic small-for-gestational-age infants showed cardiomegaly in 10 infants, 4 had heart failure. None of the infants had respiratory distress syndrome, congenital heart disease, septicaemia, anaemia or polycythaemia; infants of diabetic mothers were excluded. Cardiomegaly disappeared with the normalization of blood glucose in most of the cases. The cause of the cardiomegaly and heart failure might be related to insufficient cardiac energy substrates in small-for-gestational-age infants. This condition should also be considered in the differential diagnosis of cardiomegaly and heart failure.

Cardiomegaly↗
PubMedDate not supplied

The histology of the lung in neonates with tricuspid valve disease and gross cardiomegaly due to severe regurgitation.

Lung autopsies from four neonates with Ebstein's anomaly or tricuspid valve dysplasia and gross cardiomegaly were examined. The mean cardiothoracic ratio was 92 +/- 0.5%. The degrees of pulmonary hypoplasia and pulmonary artery muscularization were assessed and were compared with those in lungs from four controls and four patients with diaphragmatic hernias. Lung and body weight ratios and radial alveolar counts, which reflect pulmonary hypoplasia and immaturity, were significantly decreased only in patients with diaphragmatic hernia. The thickness of the medical muscle layer in small pulmonary arteries was greater in patients with diaphragmatic hernia; however, in patients with tricuspid valve disease, it was relatively small. Abnormal vascular muscle extension was seen only in patients with diaphragmatic hernia. In the cases of tricuspid valve disease, although cardiomegaly and lung compression were severe, lung hypoplasia and immaturity were not, and neither abnormal medial thickening nor extension were found. Our results suggest that, at least in full-term infants with tricuspid valve disease, surgical relief of lung compression may improve respiratory function, even if the cardiomegaly is severe.

Birth Weight↗
PubMed2005

The value of portable ultrasound for evaluation of cardiomegaly patients presenting at the emergency department.

OBJECTIVES: The purpose of this study was to evaluate the value of a hand-carried portable ultrasound device in the emergency department for patients with cardiomegaly and evaluate its impact on diagnosis and treatment. We compared the results of the portable ultrasound with the results of physical examination and with standard echocardiograph (SE) in the cardiomegaly patients in emergency department. BACKGROUND: Recently, small portable ultrasound devices have been introduced, and they need more extensive study to evaluate their application. METHODS: We used the OptiGo (Agilent Technologies, Andover, MA) portable device to evaluate emergency patients, and compared it with two SE devices available for this study, the Hewlett Packard (Sono 5500; Andover, MA) or the Vingmed (System V; Horten, Norway). Each of 100 patients was studied by physical examination first then examined with the portable ultrasound and standard echocardiography. The yields from physical examination and portable echocardiography were compared and results of the standard and portable were also compared. RESULTS: There were a total of 243 cardiovascular findings detected by the standard echocardiographic examination in the 100 patients studied. Cardiac examination failed to detect 40% of the overall findings but the portable device missed only 17% of all findings. The portable device evaluated 201 conditions correctly (83%) and missed relevant clinical findings in 37 (17%) as compared to standard echocardiography, but in only 12 (5%) were these findings of major importance As an overall measure of diagnostic value, the portable device would have added to clinical judgment, thus boosting diagnostic accuracy from 62% to 83%. CONCLUSIONS: Portable ultrasound technology can provide rapid, readily available and important clinical information for emergency physicians in the management of emergency patients with cardiomegaly.

Adult↗
PubMed1977

Thymolipoma simulating cardiomegaly: a clinicopathological rarity.

This report describes a 19-year-old girl with a chest radiograph strongly suggestive of cardiomegaly. Although she did not consent to haemodynamic studies, cardiomegaly wasru led out on the basis of the clinical course. Careful radiological study proved the existence of a large mass in the anterior mediastinum, simulating cardiomegaly. At thoracotomy a thymolipoma weighing 450 g was resected. The pathogenesis of thymolipoma is discussed.

Adult↗
PubMed1984

Persistent cardiomegaly induced by carbon monoxide and associated tachycardia.

To explore the effect of persistent cardiomegaly on cardiovascular function, groups of newborn rats inhaled up to 500 ppm CO for 33 days, after which development continued in ambient air. In the first two experiments hemodynamics were assessed by use of an anesthetized open-chest preparation; in the third experiment heart rate (HR) and arterial systolic blood pressure (BP) were monitored by auscultation in the conscious state. In all three experiments weights of left ventricle (LV) plus interventricular septum (S), both ventricles (2V), and right ventricle (RV) were significantly greater by prediction on the basis of body weight (BW) than for normal rats at 87-97, 166-176, and 337-339 days of age in females and 98-108, 177-183, and 337-339 days of age in males. 2V/BW ratio was significantly greater than littermate controls in all six instances. In all but one case (male, 177-183 days) the RV/(LV+S) weight ratios were significantly greater than the respective control groups. In experiments 1 and 2 unconscious HR was significantly elevated in females at 87-97 days and in males at 98-108 and 177-183 days. The first derivative of LV pressure rise was also increased. There was no significant change in BP or other hemodynamic parameters. In experiment 3 awake HR was elevated above controls in previously CO-treated males and females at six monitoring points between 78 and 200 days, whereas BP was not altered. BW of previously CO-exposed males was depressed and returned to normal only after 290 days. A similar decrement in BW was not seen in females. Neonatal CO inhalation and cardiomegaly causes persistent cardiomegaly and tachycardia, lasting a significant fraction of the maximal life span of the rat in both sexes.

Animals↗
PubMed1981

Cardiomyopathy with cardiomegaly: a diagnostic dilemma.

The clinical angiographic, and available autopsy data of 32 patients with cardiomyopathy with cardiomegaly were reviewed. Twenty-six patients had alcoholic cardiomyopathy. Of these, 20 patients had patient coronary arteries, and 6 had significant occlusive coronary artery disease. Six patients denied any history of excessive alcohol intake, had significant occlusive coronary artery disease, and were grouped as ischemic cardiomyopathic. A total of 12 patients (37.5%) had significant occlusive coronary artery disease. The clinical separation of patients with cardiomegaly due to alcoholic cardiomyopathy from those with occlusive coronary artery disease is extremely difficult. Clinical parameters, including history of chest pain and presence of absence of abnormal Q waves on electrocardiograms, are of little value in individual cases. It seems likely that many patients with ischemic cardiomyopathy may present clinically and electrocardiographically as patients with silent occlusive coronary artery disease. This study underlines the importance of coronary angiography in making a precise diagnosis. The mortality rate during the 5-year follow-up period was 56%. The patients with alcoholic cardiomyopathy with occlusive coronary artery disease carried the worst prognosis. The outlook for patients with cardiomyopathy and cardiomegaly becomes grave once they develop left ventricular end diastolic pressure over 24 mm Hg.

Adult↗
PubMed1993

Fluid retention and cardiomegaly associated with carbamazepine in an epileptic child.

Carbamazepine (CBZ) has been reported to have an antidiuretic action, though it is not known how it produces this effect. This is a well recognized complication of CBZ therapy in adults. However this syndrome has been rarely observed in childhood. We present an epileptic child with fluid overload due to CBZ treatment who was referred with chest pain and cardiomegaly. Our patient developed fluid retention with cardiomegaly during treatment with CBZ alone at a normal dose and for a short time. To our knowledge this is the first case of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) due to CBZ therapy which has been observed to be associated with cardiomegaly.

Adolescent↗
PubMed1985

Thyroxine cardiomegaly in rats is not hypertension-bound.

For 13-27 days, male rats were given dried thyroid (Thyreoidin SPOFA) in their food, 0.9% NaCl to drink instead of water, or both. In all the experiments, Thyreoidin induced pronounced cardiomegaly. The blood pressure rose only after 0.9% NaCl combined with Thyreoidin and only in experiments lasting 13 or 16 days (not 25 and 27 days). After three weeks of the experiment, therefore, hypertension disappeared, but cardiomegaly persisted. In all the experimental groups, including the controls, a significant positive correlation was found between heart weight and adrenal weight, but not between heart weight and blood pressure or between adrenal weight and blood pressure. The adrenals may thus participate in some way in the development of thyroxine cardiomegaly.

Adrenal Glands↗
PubMed1994

[An autopsied case of Fabry's disease presenting with parkinsonism and cardiomegaly as a cardinal clinical manifestation].

A 68-year-old male had been followed up under a clinical diagnosis of parkinsonism for 5 years. He was admitted to the Kanto Teishin Hospital with a chief complaint of difficulty in swallowing. Physical findings were almost normal. Neurological examination showed parkinsonism including mask-like face, positive Myerson's sign, mild rigidity, marche à petit pas, and retropulsion, and pyramidal signs including mild right hemiparesis, generalized hyperreflexia and positive Babinski's sign on both sides. Routine blood analysis was normal, except for elevated LDH level. He was found to have cardiac enlargement (CTR 58.7%) in chest roentogenogram, left ventricular hypertrophy (LVH), right bundle branch block and myocardial ischemia in electrocardiogram, as well as LVH, asymmetrical septal hypertrophy, mild MR and AR in echocardiogram. A T2 weighted brain MRI disclosed multiple high signal intensities in the basal ganglia and deep white matter regions which suggest parkinsonism resulting from multiple cerebral infarctions. An upper gastrointestinal endoscopic examination revealed esophageal and gastric carcinomas. He died of ventricular fibrillation 14 days after an operation of these carcinomas. Autopsy showed severe cardiomegaly (800 g) and vacuolar change of myocardium with lamellar body on electron microscopic examination. A definite biochemical diagnosis of Fabry's disease was made by demonstration of deposition of a large amount of trihexosylceramide in the myocardium, kidney, and liver. This case presented parkinsonism and cardiomegaly without typical signs of Fabry's disease. Therefore, Fabry's disease should be considered as one of possible underlying diseases, when a patient has cardiomegaly or ischemic cerebrovascular disease without risk factors, even if he has no typical signs of Fabry's disease.

Aged↗
PubMed1971

Prognosis of idiopathic cardiomegaly in Jamaica with reference to the coronary arteries and other factors.

Clinical and epidemiological features of idiopathic cardiomegaly in Jamaica are reviewed, and the high community prevalence of the disorder is shown. The frequent occurrence of sudden or unexpected death in patients whose earlier electrocardiograms had shown repeated ventricular ectopic beats has been noted. Common electrocardiographic findings included a high rate of abnormalities usually regarded as indicative of coronary artery disease: cardiac arrhythmias, particularly multiple ventricular extrasystoles; and high voltage complexes characteristic of left ventricular hypertrophy. The differences and similarities between idiopathic cardiomegaly and coronary heart disease are shown. A possible role for intramuscular lignocaine in the control of the chronic ventricular ectopic rhythms is demonstrated. There is a statistically significant association between idiopathic cardiomegaly and positive serological tests for treponemal infection. The hearts are invariably hypertrophied at necropsy. In some hearts the smaller intramuscular coronary arteries show occlusive changes. Their possible nature and significance are discussed.

Adult↗
PubMed1976

Idiopathic cardiomegaly in Africa.

Idiopathic cardiomegaly is probably the commonest single diagnosis other than hypertension made in tropical and subtropical African cardiovascular practice. Understanding of the nature of this disease has been hampered by failure to recognize the possibility that the term "idiopathic cardiomegaly" may embrace several disease entities. Evidence suggests that many factors, sometimes acting singly, but often acting in combination, may be responsible for the genesis of so-called idiopathic myocardial failure. The future attitude to research should not be one of excluding well-defined forms from the concept of idiopathic cardiomegaly, but one of clinicopathological classification, which should be a prelude to the search, within each moiety of this group of disorders, for a specific or dominant etiological factor.

Adult↗
PubMed2003

Isolated cardiomegaly in the second trimester as an early sign of fetal hydrops due to intracranial arteriovenous malformation.

We report the case of a 27-year-old pregnant woman in whom isolated mild fetal cardiomegaly, diagnosed prenatally on sonographic examination at 22 weeks' menstrual age, was the first sign of development of an arteriovenous malformation of the vein of Galen. The arteriovenous malformation was visualized on sonographic examination at 29 weeks' menstrual age; prenatal MRI at 32 weeks confirmed the diagnosis. At 34 weeks' menstrual age, repeat sonographic examination demonstrated polyhydramnios, cardiomegaly, and generalized hydrops with ascites and pleural effusion. After vaginal delivery, the male neonate died of respiratory distress. We present the findings of prenatal gray-scale, color Doppler, and power Doppler sonography; MRI; and postmortem examination.

Cardiomegaly↗
PubMed1983

Cardiomegaly in Northern Zambia: clinico-pathological observations.

Massive cardiomegaly (heart weight above 400 g in females and 450 g in males) was studied in 26 Zambians examined post mortem. The aetiologies found were: hypertensive heart disease alone in six cases; hypertensive and alcoholic heart disease in two cases; alcoholic heart disease alone in five; alcoholic and pulmonary heart disease in one; alcohol with possible hypertensive heart disease in one. Eleven cases were classified as being idiopathic mainly due to lack of data and in five of these hypertension was suspected as being the cause. The series qualitatively represented the spectrum of non-rheumatic heart disease seen in patients admitted to the Central Hospital, Ndola, Zambia. Hypertension had a central role in the causation of massive cardiomegaly. Follow-up of several patients enabled observations on the cardiac effects of hypertension and alcoholism operating simultaneously and on the relationship between hypertension and congestive cardiomyopathy.

Adult↗
PubMed1977

Familial occurrence of sinus bradycardia, short PR interval, intraventricular conduction defects, recurrent supraventricular tachycardia, and cardiomegaly.

Four members of a family presenting with sinus bradycardia, a short P-R interval, intraventricular conduction defects, recurrent supraventricular tachycardia (SVT), syncope, and cardiomegaly had His bundle studies and were found to have markedly shortened A-H intervals (30 to 55 msec.) with normal H-V times (35 to 50 msec.). Right atrial pacing at rates as high as 170 to 215 per minute failed to increase the A-H or H-V intervals significantly. The data are compatible with the presence of an A-V nodal bypass tract (James bundle) or even complete absence of an A-V node. Ventricular pacing and spontaneous ventricular premature beats resulted in a short ventriculoatrial conduction time (110 msec.) suggesting that if A-V nodal bypass tracts exist, they are utilized in an antegrade and retrograde fashion. None of the features of WPW syndrome was present. The mechanism of syncope in the mother and daughter was intermittent third-degree heart block. Both went on to develop permanent complete heart block despite electrophysiologic studies demonstrating 1:1 A-V conduction at extremely rapid atrial pacing rates and both required implantation of permanent pacemakers. The mechanism of syncope in the two brothers was possibly marked sinus bradycardia, but transient complete heart block has not been ruled out. Permanent pacemaker therapy was recommended for both. The nature of the cardiomegaly, which was mild in three patients, is not known. Although not well documented, several maternal relatives have had enlarged hearts, SVT, complete heart block, and syncope.

Adolescent↗
PubMed1999

["Cardiomegaly and pneumonia"--a misdiagnosis in long-standing achalasia].

HISTORY: A 65-year-old woman was admitted to another hospital with suspected status asthmaticus. While there was progressive respiratory failure, the chest X-ray showed bilateral congestion and infiltration with widened mediastinum and cardiomegaly. The patient was transferred to the authors' hospital after two days on ventilatory support because of suspected left-ventricular failure and pulmonary congestion with pneumonia. 30 years previously she had undergone a myotomy for achalasia. INVESTIGATIONS: Imaging of the oesophagus with water-soluble contrast medium, computed tomography of the thorax and gastroscopy revealed a siphon-like megaoesophagus (which had been misinterpreted radiologically as cardiomegaly) with a slightly open lower oesophageal sphincter. The pulmonary symptoms were thought to be due to aspiration pneumonia. TREATMENT AND COURSE: As there were no other reasonable treatment options a transmediastinal oesophageal resection with gastric pull-through and collar anastomosis was performed. CONCLUSION: In long-standing achalasia a megaoesophagus can develop despite previous myotomy. It should be included in the differential diagnosis of radiologically demonstrated mediastinal enlargement.

Aged↗
PubMed1984

Cardiac compliance and dimensions in carbon monoxide-induced cardiomegaly.

Adult male rats inhaled 500 ppm CO continuously for 38 to 47 days to produce significant cardiomegaly. In a first experiment in which heart wall stiffness was examined, haematocrit rose 45.1% and the ratio of the sum of right ventricle (RV) and left ventricle (LV) to body weight (mg X g-1) increased from 2.69 to 3.34. Compliance (ml X mmHg-1) of CO LV's and RV's studied from 0 to 25 mmHg intraluminal pressure, was generally greater than that of LV's and RV's from controls at the same pressure. These differences were greater for RV's. There was no difference between control RV's and LV's at the same distending pressure. The differences between treated and control groups disappeared when compliance was normalised per g heart weight. In a second experiment in which heart dimensions were examined, haematocrit ratio increased 48.6% and 2V (RV + LV) to body weight ratio (mg X g-1) increased from 2.77 to 3.45. Atrial weight was also greater. LV apex to base length increased 6.4% and LV outside diameter increased 7.3. No significant differences in LV, RV or interventricular septum (S) thickness resulted from CO exposure, as measured at three sites in each, in four cross-sections of the heart between the apex and base. In general, LV wall was slightly thicker than S, while RV was about 35% that of LV. The findings suggest that chronic carboxyhaemoglobinaemia produces largely eccentric cardiomegaly, and that there is no intrinsic change in wall stiffness.

Animals↗