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PubMed1993

Feline bordetellosis: challenge and vaccine studies.

Four eight-week-old cats, shown to be free from feline calicivirus, feline herpesvirus and Chlamydia psittaci were challenged with an aerosol of Bordetella bronchiseptica. Within five days the cats developed signs of respiratory disease, characterised by nasal discharge, sneezing, spontaneous or induced coughing and dry or wet rales at auscultation. These signs were present for about 10 days, after which they began to resolve. To test the protective capacity of an experimental fimbrial antigen-based subunit vaccine, 10 kittens were vaccinated twice, with two weeks between the vaccinations, and five kittens were left unvaccinated. Two weeks after the booster the 15 kittens were challenged with an aerosol of B bronchiseptica as the sole pathogen. On the day of challenge the vaccinated kittens had a mean bordetella antibody titre of 2(9.5) whereas the control cats remained seronegative (titre < 2(2)). The control cats developed signs of respiratory disease after challenge, whereas the vaccinated cats were almost completely protected. The degrees of protection against rhinitis, sneezing, spontaneous or induced coughing, and dry or wet rales at auscultation were 100 per cent, 95 per cent, 95 per cent and 100 per cent, respectively. Furthermore, the vaccinated kittens cleared the challenge bacteria more quickly than the controls, resulting in a reduction of 80 per cent on days 15 and 18 after challenge and a reduction of 99 per cent on days 22 and 29 after challenge. The results show that B bronchiseptica can act as a primary pathogen in cats and that a vaccine containing the fimbrial antigen induces a protective immune response.

Animals↗
PubMed2003

Effect of birth weight on blood pressure and body size in early adolescence.

The fetal programming theory that birth weight contributes to blood pressure or body size in later life is examined in this study. A prospective longitudinal study was conducted on subjects who were examined as newborns and prospectively interviewed and re-examined at 11 to 14 years old. Low birth weight (<2500 g) was present in 36% of the sample. The adolescent examination included measurements of blood pressure (BP), both auscultation and oscillometric methods; anthropometrics (height, weight, and body mass index [BMI]); health status; and health behaviors. Data were analyzed on 250 subjects. Correlation coefficients of birth weight with all BP measures were nonsignificant, except for the last auscultated diastolic BP (r=0.19, P<0.01), which had a positive relationship. The simple correlation coefficients of birth weight with adolescent body size were significant and positive for weight and BMI. After multiple linear regression analyses with adjustments for age, Tanner stage, and gestational age, there was no significant effect of birth weight on adolescent weight or BMI. No significant correlations were detected for ponderal index at birth with adolescent measures. This study, which includes a substantial portion of low-birth-weight cases (36%), indicates that birth weight does not correlate negatively with later BP. These results do not support the low-birth-weight theory and indicate that childhood factors that are more proximal have a greater effect on adolescent BP than intrauterine factors.

Adolescent↗
PubMed1988

Neurologic manifestations of atrial myxoma. A 12-year experience and review.

We present the results of a 12-year retrospective analysis of 11 patients, eight women and three men, aged 16-76 years, with pathologically documented atrial myxomas. Nine of the 11 patients were found to have a left atrial myxoma; right atrial myxomas were identified in two. Five of the 11 patients (45%) had abnormalities on neurologic examination, and five of five had computed tomographic evidence of nonhemorrhagic cerebral infarction. Neurologic symptoms were the initial presentation in four patients. Six patients reported a history of cardiac disease; eight of the 11 had abnormalities on cardiac auscultation. Echocardiography in 10 patients was diagnostic in all but one. Gated magnetic resonance imaging of the heart in two patients demonstrated myxoma position and movement. Follow-up examinations (varying from 1 month to 7 years after tumor resection) in nine of 11 patients demonstrated no recurrent neurologic symptoms. Cerebral infarction is a common complication of atrial myxomas and may be the presenting feature. Recurrent cerebral emboli before surgery is not uncommon. Cardiac auscultation may be normal, and electrocardiographic changes are often nonspecific. Delayed neurologic events following surgery are rare.

Adolescent↗
PubMed1997

Chronic respiratory disease morbidity in construction workers: patterns and prognostic significance for permanent disability and overall mortality.

The aim of this study was to determine chronic respiratory disease morbidity in construction workers, and to assess the prognostic value of various morbidity measures on permanent disability and on all-cause mortality. Subjects in this analysis were male employees in the German construction industry, aged 40-64 yrs, who were examined by the occupational health service between August 1986 and December 1988. Prevalence of respiratory disorders as characterized by: 1) pathological findings on lung auscultation; 2) reduced forced expiratory volume in one second (FEV1); and 3) a medical diagnosis of chronic respiratory disease (International Classification of Diseases 9th revision (ICD-9) 490496) was assessed among occupational groups of construction workers, and compared with prevalence among white-collar employees. Active follow-up was conducted between October 1992 and July 1994 to ascertain working and life status (completeness: 92 and 96%, respectively). The prognostic value of the morbidity measures on permanent disability and on all-cause mortality was assessed using the Cox proportional hazards model. In the entire cohort, crude prevalence was 7.6% for pathological findings on lung auscultation, 8.8% for a reduced FEV1 (<70% of predicted value), and 6.1% for a recorded diagnosis of chronic respiratory disease. There was strong variation of prevalence with age, smoking status and, less clearly, occupation. The relative risk for permanent disability varied between 1.9 and 3.2, and for mortality between 2.0 and 2.9, respectively, when men with the various measures of bronchopulmonary disorders were compared with other men. The morbidity measures utilized allow the identification of employees at higher risk of disability and death, and this may facilitate targeting of specific prevention and rehabilitation measures.

Adult↗
PubMed2004

A decision tree--based method for the differential diagnosis of Aortic Stenosis from Mitral Regurgitation using heart sounds.

BACKGROUND: New technologies like echocardiography, color Doppler, CT, and MRI provide more direct and accurate evidence of heart disease than heart auscultation. However, these modalities are costly, large in size and operationally complex and therefore are not suitable for use in rural areas, in homecare and generally in primary healthcare set-ups. Furthermore the majority of internal medicine and cardiology training programs underestimate the value of cardiac auscultation and junior clinicians are not adequately trained in this field. Therefore efficient decision support systems would be very useful for supporting clinicians to make better heart sound diagnosis. In this study a rule-based method, based on decision trees, has been developed for differential diagnosis between "clear" Aortic Stenosis (AS) and "clear" Mitral Regurgitation (MR) using heart sounds. METHODS: For the purposes of our experiment we used a collection of 84 heart sound signals including 41 heart sound signals with "clear" AS systolic murmur and 43 with "clear" MR systolic murmur. Signals were initially preprocessed to detect 1st and 2nd heart sounds. Next a total of 100 features were determined for every heart sound signal and relevance to the differentiation between AS and MR was estimated. The performance of fully expanded decision tree classifiers and Pruned decision tree classifiers were studied based on various training and test datasets. Similarly, pruned decision tree classifiers were used to examine their differentiation capabilities. In order to build a generalized decision support system for heart sound diagnosis, we have divided the problem into sub problems, dealing with either one morphological characteristic of the heart-sound waveform or with difficult to distinguish cases. RESULTS: Relevance analysis on the different heart sound features demonstrated that the most relevant features are the frequency features and the morphological features that describe S1, S2 and the systolic murmur. The results are compatible with the physical understanding of the problem since AS and MR systolic murmurs have different frequency contents and different waveform shapes. On the contrary, in the diastolic phase there is no murmur in both diseases which results in the fact that the diastolic phase signals cannot contribute to the differentiation between AS and MR. We used a fully expanded decision tree classifier with a training set of 34 records and a test set of 50 records which resulted in a classification accuracy (total corrects/total tested) of 90% (45 correct/50 total records). Furthermore, the method proved to correctly classify both AS and MR cases since the partial AS and MR accuracies were 91.6% and 88.5% respectively. Similar accuracy was achieved using decision trees with a fraction of the 100 features (the most relevant). Pruned Differentiation decision trees did not significantly change the classification accuracy of the decision trees both in terms of partial classification and overall classification as well. DISCUSSION: Present work has indicated that decision tree algorithms decision tree algorithms can be successfully used as a basis for a decision support system to assist young and inexperienced clinicians to make better heart sound diagnosis. Furthermore, Relevance Analysis can be used to determine a small critical subset, from the initial set of features, which contains most of the information required for the differentiation. Decision tree structures, if properly trained can increase their classification accuracy in new test data sets. The classification accuracy and the generalization capabilities of the Fully Expanded decision tree structures and the Pruned decision tree structures have not significant difference for this examined sub-problem. However, the generalization capabilities of the decision tree based methods were found to be satisfactory. Decision tree structures were tested on various training and test data set and the classification accuracy was found to be consistently high.

Algorithms↗
PubMed2006

Sensitivity of bronchial responsiveness measurements in young infants.

OBJECTIVES: There is limited evidence on the preferred methods for evaluating lung function in infancy. The objective of this study was to compare sensitivity and repeatability of indexes of lung function in young infants during induced airway obstruction. METHODS: The study population consisted of 402 infants (median age, 6 weeks). Forced flow-volume measurements were obtained by the raised volume rapid thoracoabdominal compression technique and were compared with indexes of tidal breathing, measurements of transcutaneous oxygen (Ptco(2)), and auscultation during methacholine challenge testing. RESULTS: Ptco(2) was the most sensitive parameter to detect increasing airway obstruction during methacholine challenge, followed by forced expiratory volume at 0.5 s (FEV(0.5)). Both were superior to other indexes of forced spirometry as well as tidal breathing indexes and auscultation. Coefficients of variations for Ptco(2) and FEV(0.5) were 4% and 7%, respectively. CONCLUSIONS: Ptco(2) and FEV(0.5) are the most sensitive parameters for measurement of bronchial responsiveness in young infants. Measurements of baseline lung function should preferably be made using FEV(0.5.) Measurements of bronchial responsiveness are best assessed using Ptco(2), which may be performed in nonsedated infants and improve feasibility of future studies on lung function in infancy.

Asthma↗
PubMed1996

Comments on past and present situation of intensive monitoring of the fetus during labor.

Modern intensive monitoring of the fetus during labor affords the opportunity for the greatest possible safety to the infant, whilst at the same time dispensing with unnecessary operations to terminate labor which can be dangerous for the mother and her child. Developments over the past 28 years, since cardiotocography has been in clinical use, have unfortunately also been accompanied by confusion and mistakes. We think that there are two main reasons for this: I. Many who use cardiotocography have not assessed its efficiency correctly. Heart rate pattern with all their variations have too often been regarded as the only diagnostic criteria for the determination of fetal hypoxia. However this procedure only allows a rough selection of actually endangered fetuses. In more than 50% of the cases with a suspicious or pathologic cardiotocogram there is no concrete clinical evidence of manifest danger of hypoxia. II. Investigations concerning the practical importance of monitoring the fetus during labor were often not based on actual clinical indications. Attempts were made to prove that continuous electronic monitoring of the fetal heart rate could be replaced by simple traditional auscultation. Furthermore due to failure to appreciate the real efficiency of cardiotocography, this truly excellent method was in fact blamed for the faults arising from wrong interpretation, instead of underlining the lack of logic of the investigators concerned. After all, several prospective studies, that have examined the efficiency of various monitoring strategies, demonstrate the shortcomings of these techniques in the clinical setting and have shown them to have no relevance in every practice. Presently the most suitable way to monitor the fetus during labor is to combine cardiotocography with a biochemical method. At the moment fetal blood analysis is the most suitable test to be performed in cases where the cardiotocogram is not normal. Then the role of fetal blood analysis is to find out whether in fact a danger of hypoxia is threatened or not. Today the most urgent task when monitoring the fetus during labor is not so much to reduce the number of cases of cerebral palsy since these are seldom caused by intrapartum asphyxia. The major objective is now recognised to be to prevent early morbidity of the fetus, newborn, and the consequences that flow from this. The excellent results of combined intensive monitoring of the fetus during labor are particularly well illustrated by the intrapartum mortality in our hospital during different periods when monitoring practice has been progressively and methodically improved by stages. During the period when monitoring consisted of simple auscultation used on its own, the intrapartum mortality was 0.56%. After the introduction of fetal blood analysis--at that time cardiotocography did not yet exist--the mortality sank to 0.32%. During the first ten years of cardiotocography combined with fetal blood analysis the mortality reduced further to 0.17%, and during the following 13 years it reached to a minimal level of 0.4%. Finally, in this review, other aspects are commented on such as oximetry. Oximetry, presently used as pulse oximetry, as an additional biochemical method will possibly be incorporated as the third method of monitoring the fetus during labor. Oximetry could also be used as an automatic alarm system in the labor ward when fetal O2 levels drop below a particular limit to draw the attention of the staff to the case concerned. Up to now this has not been convincingly achieved with the use of cardiotocography.

Cardiotocography↗
PubMed2004

Effects of glycopyrrolate on cardiorespiratory function in horses anesthetized with halothane and xylazine.

OBJECTIVE: To evaluate cardiopulmonary effects of glycopyrrolate in horses anesthetized with halothane and xylazine. ANIMALS: 6 horses. PROCEDURE: Horses were allocated to 2 treatment groups in a randomized complete block design. Anesthesia was maintained in mechanically ventilated horses by administration of halothane (1% end-tidal concentration) combined with a constant-rate infusion of xylazine hydrochloride (1 mg/kg/h, i.v.). Hemodynamic variables were monitored after induction of anesthesia and for 120 minutes after administration of glycopyrrolate or saline (0.9% NaCl) solution. Glycopyrrolate (2.5 microg/kg, i.v.) was administered at 10-minute intervals until heart rate (HR) increased at least 30% above baseline or a maximum cumulative dose of 7.5 microg/kg had been injected. Recovery characteristics and intestinal auscultation scores were evaluated for 24 hours after the end of anesthesia. RESULTS: Cumulative dose of glycopyrrolate administered to 5 horses was 5 microg/kg, whereas 1 horse received 7.5 microg/kg. The positive chronotropic effects of glycopyrrolate were accompanied by an increase in cardiac output, arterial blood pressure, and tissue oxygen delivery. Whereas HR increased by 53% above baseline values at 20 minutes after the last glycopyrrolate injection, cardiac output and mean arterial pressure increased by 38% and 31%, respectively. Glycopyrrolate administration was associated with impaction of the large colon in 1 horse and low intestinal auscultation scores lasting 24 hours in 3 horses. CONCLUSIONS AND CLINICAL RELEVANCE: The positive chronotropic effects of glycopyrrolate resulted in improvement of hemodynamic function in horses anesthetized with halothane and xylazine. However, prolonged intestinal stasis and colic may limit its use during anesthesia.

Adjuvants, Anesthesia↗
PubMed2004

Effects of a muscarinic type-2 antagonist on cardiorespiratory function and intestinal transit in horses anesthetized with halothane and xylazine.

OBJECTIVE: To evaluate the cardiorespiratory and intestinal effects of the muscarinic type-2 (M2) antagonist, methoctramine, in anesthetized horses. ANIMALS: 6 horses. PROCEDURE: Horses were allocated to 2 treatments in a randomized complete block design. Anesthesia was maintained with halothane (1% end-tidal concentration) combined with a constant-rate infusion of xylazine hydrochloride (1 mg/kg/h, i.v.) and mechanical ventilation. Hemodynamic variables were monitored after induction of anesthesia and for 120 minutes after administration of methoctramine or saline (0.9% NaCl) solution (control treatment). Methoctramine was given at 10-minute intervals (10 microg/kg, i.v.) until heart rate (HR) increased at least 30% above baseline values or until a maximum cumulative dose of 30 microg/kg had been administered. Recovery characteristics, intestinal auscultation scores, and intestinal transit determined by use of chromium oxide were assessed during the postanesthetic period. RESULTS: Methoctramine was given at a total cumulative dose of 30 microg/kg to 4 horses, whereas 2 horses received 10 microg/kg. Administration of methoctramine resulted in increases in HR, cardiac output, arterial blood pressure, and tissue oxygen delivery. Intestinal auscultation scores and intestinal transit time (interval to first and last detection of chromium oxide in the feces) did not differ between treatment groups. CONCLUSIONS AND CLINICAL RELEVANCE: Methoctramine improved hemodynamic function in horses anesthetized by use of halothane and xylazine without causing a clinically detectable delay in the return to normal intestinal motility during the postanesthetic period. Because of their selective positive chronotropic effects, M2 antagonists may represent a safe alternative for treatment of horses with intraoperative bradycardia.

Anesthesia, General↗
PubMed1986

An evaluation of automated indirect blood pressure measurement during pregnancy.

An automatic microcomputer-assisted instrument (Dinamap) for indirect determination of blood pressure was evaluated in 10 healthy women in the last trimester of pregnancy. Blood pressure determined intra-arterially was significantly (p less than 0.001) higher than indirect blood pressure determined with the Dinamap instrument or by manual sphygmomanometry. However, there was no significant difference in the mean change in blood pressure determined by the three techniques under investigation. A close correlation was recorded between systolic and diastolic blood pressure determined intra-arterially and with the Dinamap instrument (r = 0.92, r = 0.90), and between blood pressure determined intra-arterially and indirectly by auscultation (r = 0.93, r = 0.81). There was no significant difference in the reproducability of individual blood pressure values determined intra-arterially (systolic, 2.4 mmHg, diastolic, 3.7 mmHg) or by the Dinamap instrument (systolic, 2.8 mmHg, diastolic, 3.4 mmHg) or by auscultation (systolic, 5.0 mmHg, diastolic, 4.9 mm Hg). The Dinamap instrument proved reliable for the measurement of changes in blood pressure during late pregnancy. The technique eliminates the problem of inter-observer error which otherwise becomes evident when checking blood pressure antenatally.

Adult↗
PubMed2005

Esophageal rupture due to Sengstaken-Blakemore tube misplacement.

The author presents three cases of esophageal rupture during the treatment of massive esophageal variceal bleeding with Sengstaken-Blakemore (SB) tube. In each case, simple auscultation was used to guide SB tube insertion, with chest radiograph obtained only after complete inflation of the gastric balloon. Two patients died of hemorrhagic shock and one died of mediastinitis. The author suggests that confirmation of SB tube placement by auscultation alone may not be adequate. Routine chest radiographs should be obtained before and after full inflation of the gastric balloon to confirm tube position and to detect tube dislocation.

Adult↗
PubMed1987

Coronary angioplasty for acute mitral regurgitation due to myocardial infarction. A nonsurgical treatment preserving mitral valve integrity.

Three patients presented to the cardiac catheterization laboratory with myocardial infarction, severe mitral regurgitation, and pulmonary edema. Two patients were in cardiogenic shock at the time of cardiac catheterization. Percutaneous transluminal coronary angioplasty was done on the occluded artery in all three patients with resolution of the pulmonary edema as well as auscultative evidence of mitral regurgitation. The mean pulmonary wedge pressure dropped from 34 to 10 mm Hg in these patients. Mean follow-up of 11.7 months showed no evidence of clinical heart failure, angina pectoris, or auscultative evidence of mitral regurgitation.

Angioplasty, Balloon↗
PubMed2000

[Prevention of perinatal asphyxia. Can more be done by fetal monitoring?].

Intrapartum death has become a rare event since the introduction of electronic fetal monitoring (EFM). Randomized studies of EFM versus intermittent auscultation show that EFM reduces the risk of low Apgar score at birth and of neonatal seizures, although it may be possible to ensure low perinatal mortality even with intermittent auscultation alone. The rate of operative deliveries may increase with EFM, at least if scalp blood sampling is not used. Since scalp blood sampling is an invasive procedure providing only temporary information, the search goes on for new methods as complements to EFM. Fetal pulse oximetry and ST-analysis of fetal ECG (STAN) are two methods currently being tested in clinical studies. Regardless of the efficiency of monitoring methods that we may develop, there will always be a need for competent staff at our labor wards. Ongoing training of staff is necessary if asphyxia is to be avoided as far as possible.

Apgar Score↗
PubMed2001

Symptoms, signs, and prescribing for acute lower respiratory tract illness.

BACKGROUND: Most patients who consult with acute lower respiratory symptoms receive antibiotics, usually without evidence of significant infection. The physical signs at presentation of acute lower respiratory tract illness and the rate at which symptoms resolve and normal activities recover is not well documented. AIM: To examine in patients with lower respiratory tract infection (LRTi), their physical signs at presentation, their relationship to antibiotic prescribing, and symptom resolution and resumption of normal activities. DESIGN OF STUDY: Analysis of data collected prospectively during presentation of acute LRTi in primary care and from patient symptom diary cards. SETTING: Forty GPs who were members of an informal Community Respiratory Infection Interest Group recruited 391 patients to the study. METHOD: Information was collected on pulse, oral temperature, respiratory rate, abnormalities on auscultation, and details of any antibiotic prescription. Patients completed symptom diary cards for the following 10 days. RESULTS: Of the 391 patients who consulted 71% received antibiotics. A minority had abnormal physical signs: 17% had a pulse greater than 90 bpm, 15% a respiratory rate greater than 20 breaths per minute, 4% had a temperature greater than 38 degrees C, and 25% had an abnormality on auscultation. Antibiotic prescribing was more common in the presence of abnormal chest signs (odds ratio = 8.71, 95% confidence interval = 3.69-20.61) or discoloured sputum (OR = 2.67, 95% CI = 1.57-4.56). Ten days after consultation, 58% of patients were still coughing and 29% had not returned to normal activities. CONCLUSION: Abnormal physical signs at presentation do not explain the high rates of antibiotic prescribing nor do they predict persisting cough and functional impairment at 10 days. Reconsultation for the same symptoms within a month is common and is strongly related to persisting cough, but not abnormalities at presentation.

Anti-Bacterial Agents↗
PubMed2001

Neltenexine tablets in smoking and non-smoking patients with COPD. A double-blind, randomised, controlled study versus placebo.

BACKGROUND: The aim of this double-blind, randomised, controlled study vs placebo was to evaluate the efficacy and tolerability of neltenexine (tablets) versus placebo (tablets), administered to smoking and non-smoking patients with chronic obstructive pulmonary disease (COPD). METHODS: Sixty patients with mild stable COPD were recruited. The exclusion criteria were lung cancer, pulmonary tuberculosis, asthma, cystic fibrosis, bronchiectasis, community-acquired pneumonia (CAP), intercurrent infections, concomitant treatment with corticosteroids, antitussives, beta2 agonists, anticholinergic and other mucolytic agents. The patients were allocated randomly to receive neltenexine (20 smokers and 20 non-smokers) or a matching placebo (20 smokers), 1 tablet twice daily for 20 days. The efficacy criteria were sputum characteristics and volume, difficulty in expectorating, cough, dyspnoea, pulmonary auscultation, forced expiratory volume in one second (FEV1), vital capacity and arterial partial oxygen pressure (PO2). Tolerability was monitored and adverse events were reported. RESULTS: At the study end, the improvement of patients treated with neltenexine (smokers and non-smokers) was greater and statistically significant as compared with the patients in the placebo group in terms of improvement of dyspnoea (p<0.02), cough (p<0.02), pulmonary auscultation (p<0.02), and difficulty in expectorating (p<0.02). Furthermore, a significant improvement of the sputum characteristics (p<0.02) and volume (p<0.01) was evidenced, as compared with patients treated with placebo, in non smoking patients treated with neltenexine and in smoking patients treated with neltenexine. CONCLUSIONS: The study confirmed earlier clinical experiences showing that neltenexine is effective in the treatment of COPD patients and highlighted the correlation between abstention from smoking and the efficacy of mucoactive treatment.

Adult↗
PubMed2003

Should cord pH be performed routinely after normal birth?

Care of women in labour and how we monitor the wellbeing of baby remains a contentious issue. The National Institute for Clinical Excellence (NICE) guidance informs us that for low risk women intermittent auscultation is the method of choice. It also informs us that cord pH sampling should be performed in those cases where there has been fetal blood sampling in labour, caesarean section, or instrumental delivery. It does not say that all babies should have their acid base or pH determined after birth (NICE, 2001: 29). Nevertheless, in the hospital where the author practiced until July 2002 it remains hospital 'policy' to perform cord sampling on all babies. The net result influenced how midwives practiced, in that many midwives felt unable in the main to go against Trust policy. It became even more difficult to encourage midwives to practise intermittent auscultation as they felt the new policy made them more fearful of not using the cardiotocograph. Even when midwives protested and put forward their case, they were forced by fear of blame and litigation to practise defensively and not in the best interests of women. Midwives made their concerns known, but the practice continues and the issues remain largely unresolved. This paper is an account not only of the impact of cord pH sampling on well babies, but also of the unequal status of midwifery in relation to medical dominance that still persists in the NHS today.

Acid-Base Equilibrium↗
PubMed2003

[Right atrial myxoma in a patient with mood disturbances].

Cardiac myxomas represents 50% of the benign heart tumors. Right atrial myxomas are more rare than left localisations. Their major risks are in occurrence of pulmonary embolisms. The clinical features are non specific and the diagnosis is based on echocardiography. The treatment of choice for myxomas is surgical removal. We report a case of 32-year-old woman with an abnormality of the heart auscultation found when examined for humour disturbance. Echocardiography revealed a giant echogene, mass of the right atrium, prolapsing in the tricuspid orifice. Per-operative findings mentioned a mass with 10 cm of length. Anatomo-pathologic results conclude to atrial myxoma. The evolution after 8 months of surgical treatment was normalisation of heart auscultation and the improvement of the patient humour.

Adult↗