Klinicheskaia meditsina
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Diastolic mitral block was revealed by ++Doppler echocardiography in patients with atrioventricular block degree I, II and III in atrial flutter. The leading mechanism in pathogenesis of diastolic mitral regurgitation lies in delayed contraction of the left ventricle in relation to the left atrium causing incomplete closure of mitral cusps. ⋯ All the patients with atrioventricular block and diastolic mitral regurgitation showed tricuspid diastolic regurgitation. Diastolic mitral regurgitation induces volumetric overloading of the left atrium.
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To differentiate between thyrotoxic myopathy and myodystrophy (of the limb-girdle type), severe myasthenia, polymyositis, Addison's disease, proximal spinal muscular atrophy, steroid myopathy and neurosis special diagnostic indices have been developed based on specific muscular weakness (and atrophy) pattern early in the disease, the sequence of separate muscles involvement as the pathological process progresses, disproportion between muscular weakness and atrophy, excessive folds of the skin above the affected muscles and the presence of deep reflexes, purposeful analysis of the anamnesis. The diagnosis is confirmed by thyroid function study and/or myopathy regression in response to antithyroid therapy.