• Title/Summary/Keyword: cardiac murmur

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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.

Congenital Aortic Valvular Stenosis: report of a case (선천성 대동맥판막 협착증 치험 1례)

  • 김병열
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.350-354
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    • 1979
  • The incidence of congenital aortic valvular stenosis has been known rare, and approximately 3-6% of congenital heart diseases. Recently, we experienced 1 case of congenital aortic valvular stenosis, and which was corrected surgically under extracorporeal circulation successfully. A 11 years old male pt. was admitted to N.M.C. because of dyspnea, dizziness, chest pain and episode of syncope. An auscultation, harsh systolic murmur [Gr. IV/VI] was noted at aortic area and also palpable strong thrill. ECG showed LVH c strain pattern and suspicious LVH finding in simple chest P-A film. In Lt. cardiac catheterization, abrupt pressure change [110mmHg] between LV & Aorta was noted across the aortic valve. And aortic insufficiency was absent, well visualized both coronary arteries and suspicious bicuspid aortic valve in aortography. Valve form was bicuspid, large one was noncoronary cusp and another cusp was Rt. & Lt. coronary cusp which was interpositioned rudimentary commissure. Central aortic orifice was about 5ram in diameter. Valvulotomy was done along the fusioned commissure between noncoronary cusp and Rt. & Lt.coronary cusp, and then short incision was added between Rt. coronary cusp & Lt. coronary cusp. Immediate postoperative course smooth but unknown cardiac arrest was noted in POD second day. Complete recovery was done without sequelae by resuscitation. After operation, clinical symptoms were subsided but systolic murmur [Gr. II/VI] was audible at aortic area, diastolic murmur was absent. ECG showed still remained LVH but much decreased R wave voltage in Lt. precordial leads. Simple chest P-A showed no interval changes compared to preop film. Control Lt. heart catheterization revealed still remained pressure gradient [40ramrig] between LV & Aorta. But much decreased pressure gradient compared to preop pressure gradient [110mmHg].

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Surgical treatment of patent ductus arteriosus in adult (성인에 있어서 동맥관개존증의 외과적 치료)

  • Mun, Byeong-Tak;Kim, Sang-Hyeong;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.32-40
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    • 1984
  • During the past six years from July 1977 to June 1983, fifteen adult patients of patent ductus arteriosus were surgically treated. The results were as follows: 1. Of the 15 patients, their age range was 17 to 34 years with a mean of 24 years, and sexual predominance was women [9. cf. 6 men]. 2. The most common symptom showed exertional dyspnea, and 10 patients were classed in NYHA class II, the rest were all class III. 3. On physical examination, all patients were auscultated continuous murmur, but concomitantly diastolic murmur was noted apical region in 2 patients. 4. On roentgenogram of chest, normal finding was 3 patients, and the other patients were revealed the evidence of pulmonary congestion. 5. The electrocardiogram was normal in 6 patients, but LVH was seen in 5, and 2 patients were LVH+ LAH. 6. Cardiac catheterization was performed in 12, and mean value of SO2[LPA-RV] was 6.3%, Q/Q 2.09, peak systolic pulmonary arterial pressure 45.3 mmHg, and Rp/Rs 0.365. 7. All operations were carried out by posterolateral thoracotomy. In 6 patients, division and suture of ductus were possible, the other patients were treated by division and ligation with heavy silk or Dacron patch. 8. Postoperative complications were hoarseness, persistent murmur, reoperation for bleeding, and atelectasis. Early and late mortality was 20% [3 patients], and cause of death was mainly aneurysmal rupture of previous operative site.

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Congenital Left Pericardial Defect: A Case Report (선천성 좌측 심낭결손증 [1례 보고])

  • 성시찬
    • Journal of Chest Surgery
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    • v.15 no.1
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    • pp.129-135
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    • 1982
  • Congenital pericardial defect is a rare anomaly, which was first described by M. Columbus in 1559. Four hundred years later the first clinical diagnosis was reported by Ellis et al. The congenital pericardial defect Is usually asymptomatic and Is found Incidentally at thoracotomy and autopsy, but it appears that partial absence of pericardium Is not Innocuous because of sudden death due to herniation of a portion of heart. We experienced congenital left pericardial defect in 20 year old female who was diagnosed as left ventricular aneurysm before operation. This patient complained of dyspnea on exertion and anterior chest discomfortness. Physical examination revealed Grade II pansystolic murmur on the 3rd and 4th intercostal space left sternal border. There were specific abnormal findings on the chest plain film, EKG, ultrasonography, and left ventriculography. On 9th July 1981, an operation was performed and found the left partial pericardial defect through which a large portion of left ventricle was herniated Into left pleural space. The method of operation was removal of adhesion and widening of the pericardial defect to avoid Incarceration. After operation, we observed marked Improvement of symptoms and disappearance of cardiac murmur.

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Traumatic Cardiac Perforation (외상성 심장파열의 외과적 고찰)

  • 성시찬
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.365-370
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    • 1979
  • The first Mitral Commissurotomy was performed for tight mitral stenosis on March 1957. The patient was at that time 22-year-old male, student. The longest follow 9p for 22 years and 8 months has been obtained. During the follow up period, late deterioration due to restenosis developed 4 years after initial good result and reoperation was succeeded by transventricular Mitral Valvotomy with Tubb`s ilator on April 1964. The possible cause of restenosis was attributed to recurrent rheumatic activity. After more than 13 years long-good life following 2nd operation, Endocarditis such as episode of high fever & chill intermittently followed by mild fever and night sweat, I t. tibial artery embolization and rupture of aortic cusp. At present, patient complained of no subjective symptom, enjoying ordinary life {NYHA II]. Blood pressure has been 110/50-60 mmHg, trivial diastolic murmur at apex and moderate degree of mechanical murmur on diastole at Erb`s rea. Neither signs of RVH for mitral stenosis nor sign of LVH. ST-T change for aortic regurgitation appeared yet during last 2 yrs. The patient`s are for prevention of Rheumatic activity and development of endocarditis is important for obtaining the better long-term result.

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Successful Removal of a Cardiac Fibroma in Infant (신생아에서 발생한 심장 섬유종의 외과적 치료 -1례 보고-)

  • Kim, Si-Ho;Jo, Beom-Gu;Hong, Yu-Seon
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.491-494
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    • 1995
  • A fibroma arising in the right ventricle outflow tract of a 14 month-old infant was successfully removed. The patient was first seen because of shortness of breath and tachycardia. Pertinent clinical and laboratory findings included a grade II/VI systolic murmur, blood pressure of 120/60 mmHg, slight cardiomegaly on chest X-ray, a mass obstructing the outflow tract of the right ventricle on echocardiography and magnetic resonance imaging. On october 30,1992, under cardiopulmonary bypass, a 4cm x 3cm x 3cm tumor was resected from the right ventricular outflow tract, together with a portion of the ventricular wall. Histologically, it was diagnosis as a fibroma. The patient was sent home on the 6th postoperative day following an uneventful recovery form the operation. Although cardiac fibroma is the second most common cardiac tumor in infancy and childhood, it is usually found in the left ventricle and one arising in the right ventricle is considered rare. Although it is a benign tumor, it could produce a severe cardiac dysfunction and even sudden death, depending on its size and location. With the advance in diagnostic techniques and operative management, there is a renewed interest in the early detection and operative removal of these tumors. The case herein presented is the first such case successfully managed and reported in the Korean literature.

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Intraaortic Closure of Recanalized PDa with Aneurysmal Formation using Left Heart Bypass (좌심 체외순환을 이용한 재개통된 동맥관 개존증 - 수술 치험 1례 -)

  • 최필조
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.178-181
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    • 1990
  • We experienced a rare case of a recanalization and aneurysmal formation of the previously ligated PDA on 18 year-old-girl. Continuous murmur was noted 3 months after operation and this recanalization was confirmed by angiography and cardiac catheterization. It was impossible to mobilize aneurysmal PDA with safety, so we closed the defect using left heart bypass to prevent spinal card injury. Postoperative course was uneventful and the patient was discharged in good condition.

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Operation of Coronary AV Fistula: a report of a case (관상동맥정맥루의 외과적 수술 1례)

  • Sim, Yeong-Mok;Hong, Jang-Su;Suh, Kyung-Pill
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.91-94
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    • 1981
  • Coronary arterial fistula was first described by Krause in 1865. Since then more than 200 examples of this lesion have been reported In the literature. It is relatively rare disease and it more commonly originate in the right than in the left coronary artery. A 9-year old male was admitted with the chief complaint of cardiac murmur and diagnosed as coronary A-V fistula at middle segment of the right coronary artery by cardiac catheterization and aortography. On the operation field, the right coronary artery was markedly dilated as one cm. in diameter from the aorta to the middle segment at acute angle of the right ventricle. Fistula opening was obliterated by one stitch horizontal mattress suture with pledget. Postoperative course was uneventful and discharged without problem.

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Right coronary artery-right ventricular fistula -Report of one case- (관상동정맥루의 수술치험 1례)

  • 김희준
    • Journal of Chest Surgery
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    • v.24 no.5
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    • pp.491-497
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    • 1991
  • Coronary arteriovenous fistula is a relatively rare congenital heart disease and it drains into right atrium, right ventricle, pulmonary artery, coronary sinus or superior vena cava. We experienced one case of fistulous communication between right coronary artery and right ventricle which was most common condition. The patient was a 12 year old female and the only sign was continuous cardiac murmur. The cardiac catheterization and coronary angiography showed the fistulous communication between right coronary artery and right ventricle and aneurysmal dilatation of right coronary artery. Under the cardiopulmonary bypass with the hypothermic cardioplegia, fistula opening[7mm] which was located at right ventricle below the tricuspid valve annulus between septal and posterior leaflet was closed with 4 - 0 prolene continuous suture through right ventriculotomy. Her postoperative course was uneventful.

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Coronary Arteriovenous Fistula (관상동정맥루 -수술치험 1례-)

  • 라찬영
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.829-833
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    • 1989
  • Congenital coronary arteriovenous fistula is relatively uncommon, but with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Recently we experienced one case of congenital coronary artery fistula which originated from the right coronary artery. The case was 25 year-old-male, who complained of dyspnea on exertion and continuous murmur was heard, and diagnosed as right coronary artery fistula by the cardiac catheterization and aortography. On the operation field, the right coronary artery was markedly dilated from aorta to the middle segment at acute margin of the right ventricle, which the hen-egg sized aneurysm was noticed. The dilated coronary ostium and fistular site were obliterated with several horizontal mattress sutures. And the dilated tortuous right coronary artery with aneurysm was excised. Postoperative course was uneventful and discharged without problem.

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