Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Jul 1996
Review[Doppler echocardiographic investigation of cardiomyopathies].
There are three types of cardiomyopathy: hypertrophic, dilated and restrictive. The diagnosis and prognosis of these three types may be assessed from Doppler echocardiographic data. In hypertrophic cardiomyopathy, the diagnostic criterion is parietal hypertrophy. ⋯ Restrictive types of cardiomyopathy are more rare, amyloidosis being the commonest cause. Symmetrical wall thickening and a small ventricular chamber are observed. In advanced stages with abnormal systolic function, an E/A mitral ratio > 2 and deceleration time < 150 msec, the outcome is rapidly fatal.
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Arch Mal Coeur Vaiss · Jul 1996
Case Reports[Penetrating atheromatous ulcer of the thoracic aorta. Apropos of a case].
The authors report a case of penetrating atheromatous ulceration of the descending thoracic aorta complicated by a haemothorax. Atheromatous ulceration of the aorta is usually observed in elderly hypertensives. It is caused by rupture of the internal elastic layer under an atheromatous plaque extending into the media and resulting in a parietal haematoma of the aorta. ⋯ The treatment of choice is not established because the natural history of the condition is not well known. Penetrating ulcer would seem to progress slowly to development of an aortic aneurysm. Surgery is mainly reserved for forms complicated by painful recurrences or rupture and for cases involving the ascending aorta.
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Although physiologists have recognised for many years that cardiac performance is based on two functions, systolic and diastolic, it has only been in the last 15 years that clinicians have acknowledged the essentiel role of diastole in the physiopathology of cardiac disease. Many studies have shown that left ventricular diastolic dysfunction resulting from abnormal active relaxation or changes in passive visco-elastic properties of the myocardium modulating its rigidity were responsible for decreased distensibility of the ventricle and an increase in its filling pressures. ⋯ With respect to advanced forms of restrictive cardiomyopathy, as their clinical and haemodynamic characteristics resembling constrictive pericarditis show, they demonstrate caricatural diastolic dysfunction. Finally, although the main abnormality in dilated cardiomyopathies is poor contractility, a decrease in ventricular compliance is constantly observed.