Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · May 2002
Case ReportsTransesophageal echocardiographic diagnosis of left atrial mass as thrombus by demonstrating its attachment to the patch closing atrial septal defect: a case report.
A 65-year-old-man was referred for echocardiographic examination because of palpitations. He had a history of an atrial septal defect surgically treated with an artificial synthetic polyester textile fiber patch. TTE showed a large, mobile mass in a dilated left atrium. ⋯ Transesophageal echocardiography clearly demonstrated that the mass was attached to the patch closing the atrial septal defect and the mass was confirmed as thrombus at surgery. A patient with left atrial thrombus in whom transesophageal echocardiographic demonstration of the attachment of the left atrial mass to a patch closing an atrial septal defect served as an essential clue leading to accurate diagnosis is reported. Transesophageal echocardiography is feasible to evaluate the attachment site of a left atrial mass and to lead to an accurate diagnosis.
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J Am Soc Echocardiogr · May 2002
Echocardiographic evaluation of pulmonary artery pressure with clinical correlates in predominantly obese adults.
Pulmonary artery systolic pressure (PASP) was examined in relationship to age, body mass index (BMI), the effects of comorbid disease, and standard echocardiographic measurements of cardiac chamber size, left ventricular filling patterns, and left ventricular systolic function in 5 large cohorts presenting with a primary problem of obesity. For subjects with a measurable PASP, means (+/- SD) across cohorts for age ranged from 46.0 +/- 11.2 to 54.1 +/- 12.8 years, for BMI from 26.0 +/- 4.4 to 37.2 +/- 6.1 kg/m2, and PASP (n = 1515) from 29.9 +/- 7.7 to 33.8 +/- 7.8 mm Hg. PASP 30 mm Hg or greater occurred in 46% to 66% of subjects and 35 mm Hg or greater in 16% to 36%. ⋯ Increased PASP was also significantly associated with systemic hypertension and a history of cardiovascular disease. The mean PASP in obese individuals is higher than previously reported with nearly one third having a PASP of 35 mm Hg or greater. Clinical interpretation of PASP should include BMI, age, blood pressure, and presence of cardiovascular disease.
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J Am Soc Echocardiogr · Feb 2002
Comparative StudyComparison of left atrial dimensions by transesophageal and transthoracic echocardiography.
Left atrial (LA) size, as determined by transthoracic echocardiography (TTE), predicts the risk of atrial fibrillation and stroke and the success of cardioversion. Transesophageal echocardiography (TEE) is increasingly used in these clinical situations. However, unlike TTE, measurement of LA size by TEE has not been standardized. ⋯ The measurement from this view provided a value that had the highest correlation between TTE and TEE (r = 0.758, P <.0001, 95% confidence interval 0.68-0.86; bias 0.37 +/- 1 cm). Overall, TEE underestimated the LA dimension by 9% compared with TTE. These results suggest that the short-axis view at the level of the aortic valve is the preferred site for measuring the LA dimension by TEE.
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J Am Soc Echocardiogr · Feb 2002
Case ReportsEmbolization of a huge tricuspid valve bacterial vegetation.
A case of a woman who had tricuspid valve bacterial endocarditis is presented. Her course was complicated by persistent disseminated intravascular coagulation and acute renal failure, followed by pulmonary embolization of the vegetation. Transthoracic echocardiography showed almost complete obstruction of the right pulmonary artery. The case demonstrates the impressive size to which right-sided infective vegetations can progress and the relative paucity of symptoms and hemodynamic derangements with which they may be associated, even in the context of potentially life-threatening complications.