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At least 1,531 records · Page 85Linked to original sources
PubMed2003

Chorea in a pregnant woman with rheumatic mitral stenosis.

Chorea gravidarum is a rare movement disorder of pregnancy with a broad differential diagnosis. Although often a benign condition, it may indicate underlying acute rheumatic fever, antiphospholipid antibody syndrome or a hypercoagulable state. However, now that rheumatic fever is rare in western countries, chorea gravidarum occurs most commonly in patients with chronic rheumatic heart disease. Heightened awareness of chorea gravidarum and the morbidity of the often associated rheumatic heart disease, particularly in immigrants from developing countries, is essential for early diagnosis and effective management. A case of chorea gravidarum in a woman with rheumatic mitral stenosis is described. The diagnostic approach, pathophysiology and management of this rare condition are discussed.

Adult↗
PubMed1991

Does mitral stenosis need invasive investigation?

Evaluation without catheterization of patients with valvular heart disease implies that diagnosis based upon non-invasive techniques alone are qualitatively and quantitatively correct. The diagnosis should indicate not only the valvular lesion in question but should give information about associated conditions that could influence management decisions (whether to operate or not or whether to modify the intended operation). A review of the literature shows that in mitral stenosis (MS), both pressure gradient and valve area can be obtained non-invasively (rest/exercise). These data, combined with the ultrasound appearance of the valve, subvalvular apparatus, chamber sizes, assessment of associated regurgitation and eventual pulmonary hypertension, permit a complete evaluation of the MS patient. Thus, it can be concluded that in experienced hands, the large majority of patients with MS can be assessed reliably non-invasively for clinical screening and for valve surgery. Excluding those in whom coronary angiography is mandatory, cardiac catheterization should be required only infrequently (in less than 10%). Cardiac catheterization should, however, be carried out in patients in whom technical reasons make ultrasound examinations incomplete (obesity or respiratory disease), and in patients in whom there is a discrepancy between the physical signs and the Doppler ultrasound.

Cardiac Catheterization↗
PubMed2000

Venous and arterial changes in pulmonary veno-occlusive disease, mitral stenosis and fibrosing mediastinitis.

The pathogenesis of pulmonary veno-occlusive disease (PVOD) is not known. The diagnosis of PVOD frequently relies on its histological changes since it is often difficult to distinguish clinically from primary pulmonary hypertension. This study carried out a systematic analysis of the pulmonary venous and arterial remodelling that occurs in PVOD (n=5) and compared these changes to two other diseases affecting the pulmonary veins, mitral stenosis (MS; n=6) and fibrosing mediastinitis (FM; n=2), using established morphometric techniques. In PVOD, pronounced intimal and adventitial thickening were noted in veins of all sizes and arterialization of veins >50 microm external diameter was found. Similar changes were evident in the arterial wall, but intimal thickening was less severe than in the veins and medial thickening was more pronounced in arteries <300 microm external diameter. Eccentric intimal fibrosis of the veins was also noted for the first time in PVOD, although this feature occurred less frequently (approximately one third) than in MS. Less pronounced structural remodelling was also encountered in the veins in cases of MS and FM. The severity of the venous changes in PVOD may aid its diagnosis and lend insight into its pathogenesis. However, the similarity of the vascular changes in each form of venous hypertension also suggests that pathology alone may not always differentiate between these disease states. The similarity of the vascular changes in the three forms of venous hypertension suggests that, as in pulmonary artery hypertension, pressure, per se, is one of the triggers to vascular remodelling.

Adult↗
PubMed1984

[Potentials of a noninvasive method for studying volumetric cerebral blood flow in mitral stenosis and following its surgical correction].

The volumetric parameters of the cerebral blood flow were studied in 15 patients who had undergone comissurotomy, using the comprehensive rheographic method including tetrapolar rheoencephalography and transthoracic rheography. The non-invasive method makes it possible to determine the minute's volume of the brain circulation as well as its ratio to cardiac output. The results obtained point to a positive time-course of the brain blood flow following the surgical correction of mitral stenosis. The rheographic findings were verified by the results of computer-aided angioscintigraphy of the brain which showed the validity of the technique.

Adult↗
PubMed1995

[Mitral valvuloplasty for an infant with congenital mitral stenosis-- report of a case].

A 7-month-old infant, who underwent repair of coarctation of the aorta four months ago, was readmitted for heart and respiratory failure. Preoperative serial echocardiographic studies revealed progression of mitral valvular and subvalvular stenosis. At operation the mitral valve apparatus was found to be funnel-shaped type of congenital mitral stenosis. Chordae fenestration, papillotomy and commissurotomy were performed. Intraoperative transesophageal echocardiography demonstrated increased inflow through the mitral valve apparatus. Postoperative course was uneventful, and she was discharged 28 days after operation.

Female↗
PubMed1999

[Multiple intracardiac hydatid cysts with clinical picture simulating mitral stenosis and inferior myocardial necrosis].

We report the case of a young man who was hospitalized at the Department of Cardiology for palpitations and dyspnea. Standard ECG revealed the presence of Q waves and T negative waves in the inferior leads, suggestive of myocardial necrosis. Chest X-ray test detected a round mass in the lung. Two-dimensional echocardiography revealed three cardiac cystic masses. The biggest cyst was located in the left atrium and simulated a mitral stenosis; the second cyst was located in the posterosuperior right atrial wall and the third in the posterior wall of the left ventricle. The finding was confirmed by nuclear magnetic resonance imaging. Echinococcosis was suspected based on the patient's origin (Morocco) and the echocardiographic and MR imaging, and was confirmed by a positive hemagglutination test. This case is of particular interest because of the number of cysts and their unusual localization.

Adult↗
PubMed1994

[A case of mitral stenosis with a new open pivot bileaflet valve].

The ATS Medical Open Pivot Bileaflet Valve was developed by Villafana who also developed St. Jude Medical valve and put to the first clinical use by Sadeghi on May 4, 1992. Since then, its clinical uses have been made in cases more than 1,000 in the world, centering on Europe, and its usefulness has been reported elsewhere from the aspected of its durability, anti-thrombogenic property, hemolysis, less noise and surgical operability. ATS valve was developed with 9 characteristics as (1) open pivot; (2) removed Struts; (3) wide area orifice; (4) improved stillness; (5) improved durability; (6) small loss of energy; (7) rotating orifice; (8) x-ray impermeability of orifice; (9) and easily sutured orifice. A report is made here on our experience of a clinical case of mitral stenosis by ATS valve (the first case in Japan) on September 28, 1993.

Female↗
PubMedDate not supplied

[Characteristics of glucose and lactate oxidation in the myocardium at different stages of mitral stenosis].

Content of glucose, lactate, pyruvate and cAMP was estimated in biopsy from left atrium of 120 patients with the III and IV degree of mitral valve stenosis. Content of 14CO2, developed after incubation of myocardium homogenates with labelled substrates--glucose, glucose-I-phosphate, glucose-6-phosphate, succinate, lactate, was also measured. In patients with the IV degree of mitral valve stenosis concentration of carbohydrates and cAMP was decreased in myocardium as compared with those of patients with the III degree of the disease, whereas consumption of labelled glucose, lactate and succinate was increased. Estimation of the oxidation rate of glucose phosphorylated derivatives enabled to suggest that main part of glucose carbon was involved in reactions of the Krebs cycle. At the same time, a decrease in the content of carbohydrate substrates in myocardium of patients with the IV degree of the stenosis occurred due to elevated rate of these substrates oxidation. The data obtained suggest that adaptation reactions to hemodynamic impairments were responsible for dissimilar character of glucose and lactate metabolism in myocardium of patients with various degree of mitral valve stenosis.

Glucose↗
PubMed1991

Airway obstruction and bronchial hyperresponsiveness in left ventricular failure and mitral stenosis.

Small and large airways narrow in LVF and the term cardiac asthma is often used. However, current usage of this term is inconsistent and its meaning is therefore ambiguous. The term is better avoided despite several emerging similarities with bronchial asthma. Airway narrowing may be precipitated by acute elevation of pulmonary or bronchial vascular pressures. This appears to be mainly due to reflex bronchoconstriction. The afferents of this reflex are C-fibers with their endings in the lung parenchyma, bronchi, and pulmonary blood vessels and RAR in the larger airways, and they run in the vagus nerves, as do the efferent bronchoconstrictor fibers. Chronic elevation of pulmonary vascular pressures, as in mitral stenosis, are also associated with airway narrowing. Pulmonary edema (in the absence of vascular hypertension) also causes reflex bronchoconstriction. Bronchial responsiveness to bronchoconstrictor drugs is increased in LVF, partly, at least, due to reflex mechanisms. Bronchial mucosal swelling may also contribute. Narrowing by nonreflex mechanisms definitely occurs and there is direct evidence that decreased lung volume caused by pulmonary edema may cause this. There is little evidence for bronchial narrowing due to the mechanical effect of peribronchial edema, or by swelling of the bronchial mucosa. However, edema foam may terminally cause grave obstruction. Patients with LVF are commonly treated with bronchodilator drugs, but the basis for this approach needs further clarification.

Airway Obstruction↗