Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging最新文献

{"title":"Interesting Arrhythmogenic Right Ventricular Cardiomyopathy: A Diagnosis beyond Criteria?","authors":"S. Adhyapak, A. Gupta, Jabraan Shaikh, Harshith Kramadhari, K. Varghese","doi":"10.4103/jiae.jiae_14_22","DOIUrl":"https://doi.org/10.4103/jiae.jiae_14_22","url":null,"abstract":"A normotensive, euglycemic 24-year-old male presented with presyncope. There was no history of similar episodes or loss of consciousness. No similar family history was noted. General clinical and cardiovascular examination was unremarkable. Electrocardiogram done showed wide complex tachycardia with a left bundle branch block morphology suggestive of ventricular tachycardia. The tachycardia spontaneously reverted to normal sinus rhythm. The patient subsequently had sinus bradycardia with a heart rate of 58/min and demonstrated an epsilon wave in the inferior and right-sided chest leads. His cardiac magnetic resonance imaging showed a dilated right atrium and ventricle with no fibrofatty infiltration. This patient did not fulfil the criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC) according to the 2020 criteria. He qualified for suspected ARVC. However, according to the Heart Rhythm Society guidelines of 2019, he qualified as ARVC as he met two major criteria. We report this case as we feel that the criteria for diagnosis of ARVC may not warrant strict adherence. A strong clinical suspicion is required in addition for diagnosis.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131817732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracardiac Thrombus in Community-Acquired Klebsiella pneumonia – An Unprecedented Complication","authors":"Ashish Kumar, R. Tandon, B. Mohan, N. Jain","doi":"10.4103/jiae.jiae_46_21","DOIUrl":"https://doi.org/10.4103/jiae.jiae_46_21","url":null,"abstract":"Left ventricular thrombi commonly occur in the presence of left ventricular systolic dysfunction. Their occurrence in the presence of preserved left ventricular systolic function is extremely rare. Here we present a case of a diabetic lady with community acquired Klebsiella pneumonia who also had large intraventricular thrombi which were managed conservatively.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133852746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reperfusion Injury-Related Intramyocardial Hemorrhage: Pivotal Role of Echocardiography and Magnetic Resonance Imaging in Diagnosis and Prognosis","authors":"J. Mohan, Madhu Shukla, N. Burkule","doi":"10.4103/jiae.jiae_3_22","DOIUrl":"https://doi.org/10.4103/jiae.jiae_3_22","url":null,"abstract":"Myocardial reperfusion injury is defined as the death of cardiomyocytes as a direct result of one or more events initiated by reperfusion. These events could be inflammation, oxidative stress, calcium overload, neurohumoral activation, cytotoxicity of anaerobic metabolites, etc. Intramyocardial hemorrhage as a consequence of ischemia–reperfusion injury during acute myocardial infarction and subsequently is frequent and portends worse prognosis. Animal studies have demonstrated that intramyocardial hemorrhage does not occur with ST-elevation myocardial infarction unless myocardium is reperfused with blood. Magnetic resonance imaging is the technique of choice for its detection but has limited availability in emergencies and is expensive. Echocardiography can be used for indirect myocardial tissue characterization. Echocardiography coupled with myocardial contrast imaging is increasingly being used for detecting hemorrhage in infarcted segments. In the presence of wall motion abnormality, increased segmental echogenicity, significantly increased wall thickness underlying hypermobile endocardium, and neocavitations within the myocardium are the characteristic features. Occasionally, extensive wall splitting and formation of pseudotumor due to large hematoma are the striking features of intramyocardial hemorrhage. Intramyocardial hemorrhage in acute myocardial infarction can occur during early phase, following reperfusion and during remodeling process. There is no definite echocardiographic imaging method to assess reperfusion hemorrhage in vivo, but signal-void cavity-like or cystic appearance within the myocardium in the setting of myocardial infarction is highly suggestive. Detecting hypointense area of hemorrhage could be complicated by low-intensity echoes emanating from the normal myocardium. Echocardiography should be performed in every patient before and after reperfusion therapy and serially till discharge. There are no studies comparing the diagnostic yield of echocardiography compared to magnetic resonance imaging. Those with obvious myocardial hematoma need special attention with regard to antiremodeling agents, dual antiplatelet therapy, and possibly surgery. A majority of patients with significant intramural hemorrhage end up having reduced left ventricular function, adverse remodeling, true or pseudo-aneurysms, and even heart failure although spontaneous resorption has also been reported.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"472 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123282443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drowning in the Effusion: Cardiac Tamponade as Presenting Feature of Lymphoma in a Young Boy","authors":"A. Singhi, A. Bharat, R. Varghese, K. Sivakumar","doi":"10.4103/jiae.jiae_14_21","DOIUrl":"https://doi.org/10.4103/jiae.jiae_14_21","url":null,"abstract":"Cardiac tamponade in children has multiple etiological factors such as infection, post-inflammatory, malignancy, or blunt trauma. Detailed evaluation of the accompanying clinical features along with laboratory investigations and imaging help in appropriate diagnosis and management. We describe a case where cardiac tamponade manifested as the first presentation of childhood lymphoma but was mistaken as post-traumatic hemopericardium and tamponade.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130762713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Stratification in Acute Normotensive Pulmonary Embolism– Role of Echocardiography Imaging and Biomarkers","authors":"R. Tandon, Ashutosh Kumar Singh, B. Mohan","doi":"10.4103/jiae.jiae_41_21","DOIUrl":"https://doi.org/10.4103/jiae.jiae_41_21","url":null,"abstract":"Acute pulmonary embolism (PE) is an important cause of mortality. It requires alertness to facilitate early diagnosis which becomes a benchmark for further risk stratification and optimal management. Although pulmonary artery imaging by computed tomography scan has become the gold standard in diagnosis of acute PE, echocardiography also plays a complementary role as an imaging modality in deciding about the treatment and for prognostication. Combining echocardiography with cardiac-specific biomarker assays further enhances the required diagnostic yield in the emergency setting. In this chapter, we mainly focus on the role of echocardiography along with specific biomarker assays in prognostication of acute PE patients who are normotensive at presentation.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126047843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Case: Intravascular Journey of a Benign Uterine Tumor to the Heart","authors":"Deepak Nenwani, N. Swaminathan, S. Venkatesan, C. Elangovan, K. Selvan","doi":"10.4103/jiae.jiae_10_20","DOIUrl":"https://doi.org/10.4103/jiae.jiae_10_20","url":null,"abstract":"Intravenous leiomyomatosis (IVL) is a rare neoplasm characterized by histologically benign-looking smooth muscle cell tumor mass which grows within the intrauterine and extrauterine venous system. In this report, we present an unusual case of IVL which had originated from uterus and extended throughout the right cardiac chambers. A 36-year-old female patient came with a chief complaint of palpitation for 1-month duration. She also had a history of amenorrhea for 7 months. She had abdominal distension and doughy feeling of the abdomen. Seven months prior, ultrasound abdomen done during gynecological evaluation showed fibroid uterus. Echocardiography done showed multiple masses occupying almost all of the right atrium and moving in and out of the right ventricle. Inferior vena cava (IVC) was dilated and 90% of the IVC was filled with the mass. Cardiothoracic surgery and surgical oncology references were done. The patient was planned for simultaneous abdominal and cardiothoracic surgery. Large abdominal mass along with cardiac mass was resected along with mesentery, omentum, and abdominal lymph nodes. Histopathological and microscopic report was suggestive of leiomyoma and leiomyomatosis. Lymph node microscopy showed reactive hyperplasia.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114264700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the Mystery of Young Stroke: A Rare Cardiac Manifestation of Systemic Disease","authors":"S. Deepti, A. Ahmed","doi":"10.4103/jiae.jiae_15_21","DOIUrl":"https://doi.org/10.4103/jiae.jiae_15_21","url":null,"abstract":"A 38-year-old male presented with a history of acute-onset hemiparesis 6 months back. On evaluation, he was found to have eosinophilia. Echocardiography was done which revealed a thrombus in the left atrium attached to the posterior mitral leaflet. The rest of the cardiac chambers were normal. Diagnosis of idiopathic hypereosinophilic syndrome was made after extensive evaluation. The patient was started on steroids and oral anticoagulation, following which eosinophil count and size of thrombus reduced.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130270756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Observational Data Analytical Research on Pediatric Cardiomegaly as a Predictor of Structural or Functional Heart Diseases: Chest X-ray versus Echocardiography Comparison and Contemplation","authors":"M. Tomar, F. Ahmad, M. Chaudhuri, V. Agarwal","doi":"10.4103/jiae.jiae_51_21","DOIUrl":"https://doi.org/10.4103/jiae.jiae_51_21","url":null,"abstract":"Background: Chest X-ray (CXR) is a routine, noninvasive test advised in a plethora of pediatric non-cardiac conditions such as bronchopneumonia, respiratory distress, failure to thrive, suspected tuberculosis, and for preoperative anesthesia clearance. Finding of cardiomegaly (CM) on CXR is a common cause of referral to a pediatric cardiologist. The question lies in its significance: whether CM in CXR corroborates with cardiac disease (s), structural or functional. Materials and Methods: The data of 229 children (median age: 6 months), referred to pediatric cardiology unit for echocardiography with CXR depicting CM over a period of 2 years (June 2019 to July 2021), were retrospectively reviewed. Clinical and laboratory findings, CXR, and echocardiography were analyzed for all children to determine the positive predictive value of CM in CXR to detect cardiac disease. Echocardiography was taken as gold standard to reach the cardiac diagnosis. Results: True CM was noted in 85% (Group A), whereas 15% had false CM (Group B). Group A comprised structural heart defect in 71.7% and ventricular dysfunction in 13.3%. Less common causes were severe anemia, hypertensive heart failure, arrhythmogenic cardiomyopathy, diphtheritic cardiomyopathy, multisystem inflammatory syndrome in children, pericardial effusion, thiamine deficiency, and severe idiopathic pulmonary arterial hypertension. In Group B, the most common reasons for false diagnosis were expiratory film (n = 18), thymic shadow (n = 12), and chest deformity and mediastinal mass (n = 2 each). Conclusion: CM in CXR strongly correlates with cardiac involvement and has a high positive predictive value. Combining clinical, laboratory, and CXR interpretation enables the pediatrician to achieve a rapid functional diagnosis. Medical stabilization can be initiated with this knowledge pending the availability of echocardiography in resource-limited areas. Detailed evaluation at a pediatric cardiac center should be completed to reach a final diagnosis in all such patients. In the absence of congenital heart disease, known acquired causes leading to cardiac compromise should be actively looked for.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"03 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128299550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of Caval Aorta Diameter Index by Transthoracic Echocardiogram in Normal Indian Population","authors":"S. Sompura, V. Sangareddi, N. Swaminathan","doi":"10.4103/jiae.jiae_24_21","DOIUrl":"https://doi.org/10.4103/jiae.jiae_24_21","url":null,"abstract":"Background: Bedside ultrasonography is a promising noninvasive and rapid technique to assess body fluid status. Early detection of hypovolemia and hypervolemia is crucial to guide management in critically ill patients. There is a considerable demographic variability in the normal range of inferior vena cava dimensions as seen in numerous studies and a steadfast formula to calculate caval diameter based on demographic parameters and body growth is not available till date. Caval aorta diameter index had a positive correlation with invasively measured central venous pressure as established by previous studies done in intensive care units. The simplicity of examination technique makes this index useful in every situation where body fluid status has therapeutic and prognostic implications. This study aims to identify standard normal measurement of caval aorta index by easily available two-dimensional echocardiography in subcostal view and by right coronal approach/transhepatic view in different age groups in Indian patients. Materials and Methods: One hundred and two patients referred for routine cardiac status evaluation who were asymptomatic and clinically normal without any major medical illness with normal echocardiogram were prospectively analyzed and caval aorta index assessed in both subxiphoid and transhepatic right coronal view. Results: Normal caval aorta index measured in subcostal view was 1.108 ± 0.076 and measured in transhepatic view was 1.101 ± 0.082 (mean ± 2 standard deviation). The difference of caval aorta index measured in both views was not significant statistically (P = 0.207). Conclusion: In this study, we provide a normal reference level for sonographic caval aorta index in Indian population measured in subxiphoid and transhepatic views. We also conclude that transhepatic right coronal view measurements for this index are comparable to subcostal view, so both views can be used alternatively when one window is suboptimal.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122863464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A patient with type IV unroofed coronary sinus presenting with wide QRS Tachycardia","authors":"Ashish Kumar, R. Tandon, A. Goyal, G. Wander","doi":"10.4103/jiae.jiae_25_21","DOIUrl":"https://doi.org/10.4103/jiae.jiae_25_21","url":null,"abstract":"Unroofed coronary sinus (UCS) is a congenital heart disease characterized by defects in the formation of the coronary sinus. UCS usually manifests as dyspnea on effort, fatigue, or palpitation. However, here, we present a case of a 53-year-old female whose presentation was wide QRS tachycardia. In this interesting case, we describe the role of various echocardiographic modalities used to reach its elusive diagnosis.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115297271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}