• Clinical and Experimental Pediatrics
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• 제50권11호
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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.

• Journal of Yeungnam Medical Science
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• 제37권2호
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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.

• Journal of Chest Surgery
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• 제52권2호
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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.

• Journal of Chest Surgery
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• 제48권1호
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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.

• Journal of Chest Surgery
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• 제35권9호
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• pp.680-683
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• 2002

우측 심장에 발생한 감염성 심내막염은 전체 감염성 심내막염의 5%를 차지하며 이중 70%이상에서 선천성 심기형이나 후천성 판막질환 등에 동반되어 발생한다. 환자들은 약물 남용의 과거력을 갖는 경우가 많으며, 혈액투석 등 의인성 감염성 심내막염이 발생하는 경우도 있다. 우측 심장에 발생한 감염성 심내막염은 항생제 치료에 대한 반응이 우수하고, 내과적 치료에 반응하지 않더라도 판막손상이나 색전에 의한 합병증이 상대적으로 적게 발생하기 때문에 수술이 필요하지 않은 경우가 많다. 만성신부전으로 혈액투석을 받는 환자들은 관혈적 투석경로를 통해 균혈증에 노출되고 이로 인해 감염성 심내막염이 속발된다. 본 교실에서는 혈액투석을 받던 말기신부전 환자에서 정맥내 도관과 관련하여 삼첨판막이나 폐동맥판막의 침범없이 우심방내 우종을 동반한 심내막염이 발생하였으며, 항생제 치료를 시행하였으나 반응이 없어 수술을 시행하였다. 속목정맥도관과 관련된 우측 심장의 감염성 심내막염은 혈액투석환자에서 매우 드물게 발생하지만 진단이 지연되고 이로 인해 적절한 시기에 치료를 받지 못하여 병원내 사망률을 높이므로 적극적인 진단과 처치가 필요함을 확인할 수 있었기에 이를 문헌고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제18권3호
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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.

• 한국임상수의학회지
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• 제40권2호
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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.

• 한국임상수의학회지
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• 제19권1호
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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.

• Journal of Yeungnam Medical Science
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• 제31권1호
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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.

• 한국임상수의학회지
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• 제32권4호
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• pp.301-307
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• 2015

본 연구의 목적은 적색 형광 단백질 유전자 형질 전환 복제견을 포함한 복제견들에서 측정된 심장 초음파 수치를 이전에 보고된 일반개의 정상 참고 범위와 비교하는 것이다. 일곱 마리의 복제견에서 M-mode, 2D-mode, pulsed wave Doppler 그리고 Tissue Doppler Imaging을 통해 좌심, 우심 그리고 우심실 우출로의 해부학적 특징과 심장 기능을 평가하였다. 모든 복제견들은 해부학적 구조에서 특이적인 이상을 나타내지 않았으며 측정된 수치들은 정상 참고 범위 이내에 있었다. 게다가 좌심과 우심의 심근 기능 모두 정상 참고 범위 이내에 위치하였다. 특히 복제 동물들에서 흔히 나타나는 우심 부전과 폐성 고혈압은 복제견들에서는 나타나지 않았다. 결론적으로, 성장이 끝난 복제견들에게서 는 출생시와 성장과정에서 심혈관계의 이상을 타나내는 징후는 확인되지 않았다. 그러므로 형질 전환 방법을 포함하는 체세포핵이식 기술은 복제견들의 심장 형태와 기능에 대해 심각한 부작용을 나타내지 않는다고 할 수 있다.