• Title/Summary/Keyword: Right sided heart failure

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Right-sided heart failure in congenital heart diseases (선천성 심질환에서 우심부전)

  • Jung, Jo Won
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1055-1060
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    • 2007
  • Right-sided heart failure is a major problem among patients with congenital heart diseases, due to the prevalence of congenital heart defects and the association of pulmonary hypertension. More attention is focused on the structure of the right heart particularly in association with congenital heart defects and chronic lung disease. The right ventricle (RV) may support the pulmonary circulation, and sometimes the systemic circulation (systemic RV) in congenital heart defects. Despite major progress being made, assessing the RV remains challenging, often requiring a multi-imaging approach and expertise (echocardiography, magnetic resonance imaging, nuclear and cineangiography). Evidence is accumulating that RV dysfunction develops in many of these patients and leads to considerable morbidity and mortality. While there is extensive literature on the pathophysiology and treatment of left heart failure, the data for right-sided heart failure is scarce. Therefore RV function in certain groups of congenital heart disease patients needs close surveillance and timely and appropriate intervention to optimise outcomes. An understanding of RV physiology and hemodynamics will lead to a better understanding of current and future treatment strategies for right heart failure. This will review right-sided heart failure with the implications of volume and pressure loading of the RV in congenital heart diseases.

Fatal progressive right heart failure in a pancreatic cancer patient

  • Byoun, Jeong Tae;Cho, Jae Young
    • Journal of Yeungnam Medical Science
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    • v.37 no.2
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    • pp.122-127
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    • 2020
  • Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but fatal complication of cancer and causes pulmonary hypertension and acute/subacute right heart failure. PTTM is most commonly associated with gastric cancer and more rarely associated with pancreatic cancer. We report a case of progressive right heart failure associated with clinically diagnosed pancreatic cancer, suggesting PTTM.

Temporary Right Ventricular Assist Device Insertion via Left Thoracotomy after Left Ventricular Assist Device Implantation

  • Park, Ilkun;Cho, Yang Hyun;Chung, Su Ryeun;Jeong, Dong Seop;Sung, Kiick;Kim, Wook Sung;Lee, Young Tak
    • Journal of Chest Surgery
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    • v.52 no.2
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    • pp.105-108
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    • 2019
  • Right heart failure is a relatively common complication after left ventricular assist device (LVAD) implantation. Severe right heart failure can be managed by temporary right ventricular assist device (RVAD) implantation. However, trans-sternal RVAD insertion requires a subsequent third sternotomy for cannula removal. Herein, we present a case of RVAD insertion via a left anterior mini-thoracotomy after LVAD implantation in a patient with alcohol-induced cardiomyopathy.

Potts Shunt in Patients with Primary Pulmonary Hypertension

  • Kim, Sue Hyun;Jang, Woo-Sung;Lim, Hong-Gook;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.48 no.1
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    • pp.52-54
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    • 2015
  • Idiopathic pulmonary arterial hypertension eventually leads to right-sided heart failure and sudden death. Its mortality rate in children is still high, despite improvements in pharmacological therapy, and therefore novel treatments are necessary. The Potts shunt, which creates an anastomosis between the left pulmonary artery and the descending aorta, has been proposed as a theoretically promising palliative surgical technique to decompress the right ventricle. We report the case of a 12-year-old girl with suprasystemic idiopathic pulmonary hypertension and right ventricular failure who underwent a Potts shunt for palliation with good short-term results.

Active Infective Endocarditis with Vegetation of Right Atrium in Patient with End-stage Renal Disease (말기신부전환자에서 우심방 우종을 동반한 심내막염 환자의 수술 1례)

  • Kim, Chang-Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.680-683
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    • 2002
  • Infective endocarditis that involves the right side of the heart has been estimately 5% of all cases of infective endocarditis. It has been shown that about 70% of right-sided heart infective endocarditis cases have preexisting congenital heart disease or acquired valvular lesion. It would occur in intravenous drug users or end-stage renal disease patients with indwelling venous dialysis catheter. Antibiotic therapy is more effective in the right and, when it fails, the consequence of valve disruption and emboli are less. Patients receiving long-term hemodialysis are a unique population with regard in the risk of bacteremia and subsequent infective endocarditis. We experienced one case of the active infective endocarditis with right atrial vegetation without tricuspid or pulmonary valve involvement in patient with end-stage renal disease receiving long-term hemodialysis, who needed surgical correction after medical treatment failure. Then we reported it with references that right-sided heart infective endocarditis is rare, but difficult to diagnose, life-threatening because of delayed medical treatment.

Chronic Mitral Valvular Insufficiency in Dogs (개에서의 만성 승모판 부전증)

  • 최호정;장동우;서민호;정주현;정우조;원성준;장진화;이기창;이희천
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.273-278
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    • 2001
  • Chronic mitral valvular insufficiency (CMVI) is the most common heart disease in dogs. The prevalence of CMVI is age-dependent. CMVI is usually affected to small to medium size breeds. It is more prevalent in males than females. The characteristic lesions of CMVI are caused by an acquired chronic structural degeneration of the mitral valve defined as endocardiosis or myxomatous degeneration. The main clinical signs are cough, respiratory distress, weakness and pleural effusion and ascites by secondary right-sided heart failure. The most prominent clinical finding is a systolic heart murmur. The thoracic radiography and echocardiography are useful methods in diagnosis of CMVI. Thoracic radiographic findings are left atrial enlargement, left main stem bronchial compression and pulmonary edema. Echocardiography is confirmed to increased left atrial and ventricular dimension, mitral regurgitation, mitral valve thickening and abnormal movement. Thoracic radiography and echocardiography are used to obtain a definite diagnosis of CMVI, and then to study the progression of the condition.

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Double-Chambered Right Ventricle in an Old Standard Poodle Dog

  • Yunho Jeong;Yoonhwan Kim;Eunchan Lee;Ju-Hyun An;Sooyoung Choi;Jin-Young Chung;Jin-Ok Ahn
    • Journal of Veterinary Clinics
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    • v.40 no.2
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    • pp.130-134
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    • 2023
  • A 12-year-old Standard Poodle presented with intermittent weakness and occasional dyspnea at the Veterinary Medicine Teaching Hospital of Kangwon National University. A grade of 4 out of 6 systolic murmur with an irregular tachycardic rhythm was auscultated on both sides of the chest. Systolic blood pressure was 140 mmHg. Panting was noticed in the hospital, but there was no crackle sound. Blood analysis revealed mild increases in liver panel levels (alanine aminotransferase 149 [reference interval, 19-70] U/L; and alkaline phosphatase, 185 [reference interval, 15-127] U/L) and severe increases in cardiac biomarker levels (n-terminal pro-brain natriuretic peptide, 4169 [reference interval, 50-900] pmol/L; and cardiac troponin I, 0.22 [reference interval, 0.03-0.12] ng/mL). On electrocardiography, irregularly irregular supraventricular tachycardic rhythm with an f-wave and no distinct p-wave was observed. Generalized cardiomegaly with an enlarged right atrium and left ventricle was confirmed on thoracic radiography. Moreover, hepatomegaly and an enlarged caudal vena cava were observed. Echocardiographic evaluation revealed a fibromuscular diaphragm in the right ventricle. Because of the obstructive lesion in the right ventricle, the right atrium and ventricle were enlarged (right atrial area index, 38.82 cm2/m2 [reference interval, 4.2-10.2 cm2/m2]; right ventricle end-diastolic area index, 14.152 cm2/m2 [reference interval, 4.9-10.92 cm2/m2]). Accordingly, the patient was diagnosed with double-chambered right ventricle (DCRV). Pimobendan, furosemide, enalapril, diltiazem, and S-adenosylmethionine (SAMe) were prescribed, and all symptoms were relieved. DCRV is a right-sided congenital heart defect resembling pulmonic valve stenosis. If symptoms are not severe, medical therapy can be facilitated without surgery or the balloon dilation.

Atrial Septal Defect in Dogs (개에서 심방중격결손의 증례)

  • 정주현;엄기동;장광호;오태호;이영원;장동우;윤정희
    • Journal of Veterinary Clinics
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    • v.19 no.1
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    • pp.110-113
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    • 2002
  • An atrial septal defect (ASD) is a congenital hole in the atrial septum that allows flow between the two atria. Small ASDs are usually well-tolerated defects and do not result in significant clinical abnormalities. In large ASDs or in the presence of other cardiac defects, clinically significancy is increased. Atrial septal defects in 2 Dogs with cardiac and respiratory signs were diagnosed at seoul animal medical center. In ascultation, systolic murmur and the splitting of second heart sound were heard at pulmonary or tricuspid valve region. In radiograph, right-sided cardiomegaly, pulmonary artery dilation, increased pulmonary vasculature makings, and pleural effusion or pulmonary edema signs were observed. In echocardiography, the region, location and size of septal defect was identified. Also, the direction and degree of shunt was measured. These dogs were treated with medicine for cardiac failure. One dog is well-tolerated, the other dog died.

Cardiovascular beriberi: rare cause of reversible pulmonary hypertension

  • Song, Joon Hyuk;Cheon, Sang Soo;Bae, Myung Hwan;Lee, Jang Hoon;Yang, Dong Heon;Park, Hun Sik;Cho, Yongkeun;Chae, Shung Chull
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.38-42
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    • 2014
  • Cardiovascular beriberi is caused by thiamine deficiency and usually presents as high cardiac output failure associated with predominantly right-sided heart failure and rapid recovery after treatment with thiamine. Because of its rarity in developed countries, the diagnosis can often be delayed and missed. We recently experienced a case of cardiovascular beriberi with pulmonary hypertension which successfully treated with thiamine infusion. A 50-year-old man with chronic heavy alcoholics was refered to our department for dyspnea with mental change. Echocardiography showed marked right ventricular (RV) dilatation and flattening of the interventricular septum with a D-shaped deformation of the left ventricle. Moderate tricuspid valve regurgitation was found and estimated RV systolic pressure was 52 mm Hg. Because of his confused mentality and history of chronic alcohol intake, neurological disorder due to thiamine deficiency was suspected and intravenous thiamine was administered and he continuously received a daily dose of 100 mg of thiamine. Follow up echocardiography showed marked reduction of RV dilatation and improvement of a D-shaped deformation of the left ventricle. He finally diagnosed as cardiovascular beriberi on the basis of dramatic response to intravenous thiamine. Thiamine deficiency can cause reversible pulmonary hypertension, and can still be encountered in the clinical setting. Thus high index of suspicion is critically needed for diagnosis.

Echocardiographic Evaluation of Cardiovascular Function in Cloned Dogs (심장 초음파를 이용한 복제견의 심혈관계 기능 평가)

  • Yeo, Ju-Hwan;Kim, Jae-Hwan;Kim, So-Young;Lee, Seung-Jun;Park, Noh-Won;Oh, Hyun-Ju;Kim, Min-Jung;Kim, Geon-A;Jo, Young-Kwang;Lee, Byeong-Chun;Eom, Kidong
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.301-307
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    • 2015
  • The purpose of this study was to compare echocardiographic parameters of cloned beagle dogs with the previously reported reference range. Seven cloned dogs were assessed for anatomical features and cardiac function through left- and right-sided heart and right ventricle outflow tract from M-mode, 2D-mode, pulsed wave Doppler and tissue Doppler imaging. In all the cloned dogs, there were no abnormalities in anatomical structure and measurements were within the normal reference range. In addition, left- and right-sided myocardial function was within the normal reference range. Especially, pulmonary hypertension and right-sided heart failure frequently encountered in cloned animals were not recognized in cloned dogs. In conclusion, no evidence of cardiovascular dysfunction in mature cloned dogs could be identified either at birth or the growing stage in this study. Therefore, serious adverse effects of somatic cell nuclear transfer technology including transgenesis on cardiac morphology and function were not found in cloned dogs.