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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Aneurysm I: Introduction01:30

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Mitral Valve Prolapse II: Assessment and Management01:22

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IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Left ventricular pseudoaneurysm - a challenging diagnosis.

Mariana Faustino1, Sara Ranchordás2, João Abecasis3

  • 1Serviço de Cardiologia, Hospital Fernando Fonseca, Amadora, Portugal.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|May 16, 2016
PubMed
Summary

A rare left ventricular pseudoaneurysm, a complication of myocardial infarction, can mimic other conditions. Early diagnosis via imaging and surgical repair are crucial for survival.

Keywords:
Cardiac magnetic resonanceEchocardiographyEcocardiografiaLeft ventricular pseudoaneurysmPseudoaneurisma do ventrículo esquerdoRessonância magnética cardíaca

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Imaging

Background:

  • Left ventricular pseudoaneurysm (LVPA) is a rare but life-threatening complication following acute myocardial infarction (AMI).
  • LVPA diagnosis can be challenging due to non-specific presentations, often delaying critical treatment.
  • High mortality rates are associated with untreated LVPA.

Observation:

  • A 65-year-old hypertensive patient presented with chest pain, cough, and pleural effusion, initially suspected as a pulmonary issue.
  • Symptoms were ultimately attributed to a left ventricular pseudoaneurysm resulting from a silent acute myocardial infarction.
  • Diagnosis was initially suspected with echocardiography and definitively confirmed by cardiac magnetic resonance imaging (CMR).

Findings:

  • The patient's atypical presentation stemmed from pericardial and pleural inflammatory extension of a contained myocardial rupture.
  • Echocardiography and CMR imaging were instrumental in diagnosing the LVPA.
  • Successful surgical repair of the pseudoaneurysm was performed.

Implications:

  • This case highlights the importance of a high index of suspicion for LVPA in atypical presentations post-myocardial infarction.
  • Advanced imaging modalities like CMR are vital for accurate diagnosis and timely intervention.
  • Prompt surgical management can significantly alter the disease's course and improve patient outcomes.