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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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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...
242
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

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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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Imaging Studies for Cardiovascular System II:Types of Echocardiography01:20

Imaging Studies for Cardiovascular System II:Types of Echocardiography

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Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
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Related Experiment Video

Updated: Dec 6, 2025

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

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Late-gadolinium enhancement in a subject with normal left ventricular function.

Ikuo Misumi1, Koji Sato1, Miwa Nagano1

  • 1Department of Cardiology, Kumamoto City Hospital, 4-1-60, Higashi-machi, Higashi-ku, Kumamoto City, Kumamoto 862-8505, Japan.

Radiology Case Reports
|October 5, 2020
PubMed
Summary

This case highlights that normal left ventricular function can persist despite significant left ventricular fibrosis detected via late-gadolinium enhancement. Further research is needed to understand other contributing pathophysiologies.

Keywords:
Mid-layer enhancement in late-gadolinium enhancementNormal left ventricular function

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Area of Science:

  • Cardiology
  • Cardiovascular Imaging

Background:

  • Palpitations prompted evaluation of a 27-year-old man.
  • Initial investigations including electrocardiogram, chest radiograph, and brain natriuretic peptide levels were unremarkable.

Observation:

  • Transthoracic echocardiography showed normal left ventricular structure and function, with an ejection fraction of 64% and a normal E/e' ratio of 7.5.
  • Cardiac magnetic resonance imaging revealed normal coronary arteries but extensive mid-layer left ventricular fibrosis indicated by massive late-gadolinium enhancement.

Findings:

  • The study identified a discrepancy between preserved left ventricular systolic function and significant myocardial fibrosis.
  • Massive late-gadolinium enhancement suggesting fibrosis was observed despite normal echocardiographic parameters.

Implications:

  • This case demonstrates that normal left ventricular function is possible even with substantial fibrosis.
  • Alternative pathophysiological mechanisms beyond fibrosis may explain late-gadolinium enhancement patterns and preserved cardiac function.