Marked lipomatous hypertrophy of the interventricular septum protruding into the right ventricular cavity in an asymptomatic female– a case report

Abstract Isolated sub-pulmonary membrane is a rare condition, the origin of which has been debatable. Transcatheter treatment of pulmonary valve atresia with intact interventricular septum by radiofrequency perforation and balloon dilatation to restore biventricular circulation is gaining more popularity, with improving results over time. We report in our experience of 79 cases in 10 years the development of a sub-pulmonary membrane in 4 cases: causing significant obstruction requiring surgical excision in one case that revealed a fibrous membrane on pathology; causing mild right ventricular outflow tract obstruction in another and not yet causing obstruction in 2. On cardiac MRI, the right ventricular outflow tract and the right ventricular outflow tract/pulmonary atresia angle showed no morphological abnormalities.

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Heart in Acromegaly: The Echocardiographic Characteristics of Patients Diagnosed with Acromegaly in Various Stages of the Disease

International Journal of Endocrinology ◽

10.1155/2018/6935054 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Agata Popielarz-Grygalewicz ◽

Jakub S. Gąsior ◽

Aleksandra Konwicka ◽

Paweł Grygalewicz ◽

Maria Stelmachowska-Banaś ◽

...

Keyword(s):

Right Ventricular ◽

Healthy Volunteers ◽

Global Longitudinal Strain ◽

Interventricular Septum ◽

Left Ventricular ◽

Volume Index ◽

Control Group ◽

Glucose Metabolism Disorders ◽

Acromegalic Cardiomyopathy ◽

The Right

To determine whether the echocardiographic presentation allows for diagnosis of acromegalic cardiomyopathy. 140 patients with acromegaly underwent echocardiography as part of routine diagnostics. The results were compared with the control group comprising of 52 age- and sex-matched healthy volunteers. Patients with acromegaly presented with higher BMI, prevalence of arterial hypertension, and glucose metabolism disorders (i.e., diabetes and/or prediabetes). In patients with acromegaly, the following findings were detected: increased left atrial volume index, increased interventricular septum thickness, increased posterior wall thickness, and increased left ventricular mass index, accompanied by reduced diastolic function measured by the following parameters: E’med., E/E’, and E/A. Additionally, they presented with abnormal right ventricular systolic pressure. All patients had normal systolic function measured by ejection fraction. However, the values of global longitudinal strain were slightly lower in patients than in the control group; the difference was statistically significant. There were no statistically significant differences in the size of the right and left ventricle, thickness of the right ventricular free wall, and indexed diameter of the ascending aorta between patients with acromegaly and healthy volunteers. None of 140 patients presented systolic dysfunction, which is the last phase of the so-called acromegalic cardiomyopathy. Some abnormal echocardiographic parameters found in acromegalic patients may be caused by concomitant diseases and not elevated levels of GH or IGF-1 alone. The potential role of demographic parameters like age, sex, and/or BMI requires further research.

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Metastatic adenocarcinoma involving the right ventricle and pulmonary artery leading to right heart failure: case report

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2016.0351280117 ◽

2017 ◽

Vol 136 (3) ◽

pp. 262-265 ◽

Cited By ~ 1

Author(s):

Turgut Karabag ◽

Caner Arslan ◽

Turab Yakisan ◽

Aziz Vatan ◽

Duygu Sak

Keyword(s):

Heart Failure ◽

Case Report ◽

Pulmonary Artery ◽

Right Ventricle ◽

Right Ventricular ◽

Right Ventricular Outflow Tract ◽

Right Heart Failure ◽

Ventricular Outflow Tract ◽

Right Heart ◽

The Right

ABSTRACT CONTEXT: Obstruction of the right ventricular outflow tract due to metastatic disease is rare. Clinical recognition of cardiac metastatic tumors is rare and continues to present a diagnostic and therapeutic challenge. CASE REPORT: We present the case of a patient who had severe respiratory insufficiency and whose clinical examinations revealed a giant tumor mass extending from the right ventricle to the pulmonary artery. We discuss the diagnostic and therapeutic options. CONCLUSION: In patients presenting with acute right heart failure, right ventricular masses should be kept in mind. Transthoracic echocardiography appears to be the most easily available, noninvasive, cost-effective and useful technique in making the differential diagnosis.

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Temporary transvenous endocardial pacing: method of endocardial electrode reposition in the right ventricular cavity of the heart

Kazan medical journal ◽

10.17750/kmj2016-453 ◽

2016 ◽

Vol 97 (3) ◽

pp. 453-457

Author(s):

A N Osmolovsky

Keyword(s):

Myocardial Infarction ◽

Right Ventricular ◽

Heart Rhythm ◽

Ventricular Cavity ◽

Cardiac Stimulation ◽

Artificial Pacemaker ◽

Temporary Pacing ◽

The Right ◽

Electrical Impulses ◽

Endocardial Electrode

Aim. To justify and develop method of endocardial electrode reposition in the right ventricular cavity of the heart in the spontaneous termination of temporary pacing in patients with recurrent myocardial infarction.Methods. A method of endocardial electrode reposition was used in 23 patients with myocardial infarction complicated by acute bradyarrhythmias. Written informed consent was obtained from all patients, and in the absence of contact with the patient, decision to insert temporary artificial pacemaker was made by medical consultation.Results. A method of endocardial electrode reposition that provides threading the electrode from the venous bed to the right ventricular cavity of the heart, cardiac stimulation by electrical impulses and creation the new contacts between electrode and right ventricular endocardium of the heart using the same electrode, both in the presence and in absence of the heart conduction and excitation function, was developed. At the same time, it excludes the electrode dislocation from the right ventricular cavity of the heart, provides the electrode fixation with endocardium, and at the same time allows to impose a stable artificial heart rhythm in the shortest time. During the spontaneous termination of the effective artificial pacemaker, endocardial electrodes reposition enabled to promptly regain the heart rhythm control in all 23 patients with acute bradyarrhythmia of infarction genesis.Conclusion. Effective and safe method of endocardial electrode reposition in the right ventricular cavity of the heart in the spontaneous termination of temporary pacing in patients with recurrent myocardial infarction was developed and introduced into clinical practice.

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P1344 Right ventricular mass: multimodality diagnostic approach to an incidental finding

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.781 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

J Ambrozic ◽

A Kovac ◽

R Zbacnik ◽

S Ponorac ◽

P Kogoj ◽

...

Keyword(s):

Right Ventricular ◽

Incidental Finding ◽

Contrast Echocardiography ◽

Interventricular Septum ◽

Percutaneous Biopsy ◽

Intracardiac Echocardiography ◽

Diagnostic Approach ◽

Right Ventricular Mass ◽

History Of ◽

The Right

Abstract Background Cardiac masses are rare entities and often diagnostically challenging. When incidentally found multimodality diagnostic approach is warranted for further characterization and evaluation of its contribution to the patient’s symptoms. Case report 62-year-old male, smoker, with a history of non-Hodgkin lymphoma treated with radiation and chemotherapy 10 years ago, was admitted due to subacute myocardial infarction. Coronary angiogram showed subacute occlusion of partly collateralized RCA, subsequently treated with dilatation and stenting. Echocardiography revealed signs of dilated cardiomyopathy with severely reduced left ventricular ejection fraction (EF 20%), that could be due to chemotherapy-related cardiotoxicity. On admission CTA was performed to exclude aortic dissection since the patient presented with very severe chest pain radiating to the back. It showed a heterogeneous formation within the right ventricle (RV) extending along the interventricular septum from the apex towards the tricuspid annulus, appearing to involve interventricular septum as well. According to the imaging characteristics the mass was suspected to be a liposarcoma (Figure A). With contrast echocardiography hypoechogenic formation in the RV on parasternal long-axis view could be visualized (Figure B). Due to previous history of malignancy PET scan was performed that revealed hypometabolic RV mass, suggesting a benign tumor, without any sign of metastasis. We decided for percutaneous biopsy that was done under intracardiac echocardiography (ICE) guidance using the view from the RV towards RV outflow tract (Figure C). Histology revealed proliferation of mature adipocytes, either orthotopic or multiplied (Figure D). To exclude well-differentiated liposarcoma FISH (fluorescent in situ hybridization) with amplification of MDM2 gene was undertaken, confirming benign lesion, most probably cardiac lipoma. It was concluded that the mass was an incidental finding, not related to the patient’s symptoms and not causing any functional disturbances; therefore surgical therapy could be avoided. Conclusion While echocardiography remains the first-line imaging modality, multimodality diagnostic approach is mandatory for evaluation and treatment decision of a newly-discovered cardiac mass. Histology provides definitive diagnosis and ICE could be helpful for guiding percutaneous biopsy, thus avoiding invasive open-heart procedures. Figure. Cardiac CTA (A), contrast echocardiography (B), intracardiac echocardiography (C) and histologic specimen (D) of the right ventricular mass (arrows). Abstract P1344 Figure.

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End-systolic and end-diastolic ventricular interaction

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1986.251.5.h1062 ◽

1986 ◽

Vol 251 (5) ◽

pp. H1062-H1075 ◽

Cited By ~ 11

Author(s):

B. K. Slinker ◽

S. A. Glantz

Keyword(s):

Right Ventricular ◽

Interventricular Septum ◽

Systolic Pressure ◽

Direct Interaction ◽

Ventricular Volume ◽

Left Ventricular ◽

Physiological Mechanisms ◽

In Series ◽

The Right ◽

Transient And Steady State

Right ventricular volume affects left ventricular volume via direct interaction across the interventricular septum and series interaction because the right and left hearts are connected in series through the lungs. Because it is difficult to sort out complex physiological mechanisms in the intact circulation, the relative importance of these two effects is unknown. We used statistical analyses of transient changes in left and right ventricular pressures and dimensions following pulmonary artery and venae caval constrictions to separate and quantitate the direct (immediate) from the series (delayed) interaction effects on left ventricular size at end systole and end diastole. With the pericardium closed, direct interaction was one-half as important as series interaction at end diastole and was one-third as important at end systole. With the pericardium removed, direct interaction was one-fifth as important as series interaction at end diastole and one-sixth as important at end systole. These results suggest that differences between transient and steady-state end-systolic pressure-volume relationships are largely explained by direct interaction and that direct end-systolic interaction is important for maintaining balanced right and left heart outputs.

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