Biomedical subjects

A M Lorga

Publications and source records attributed to A M Lorga.

At least 37 records · Page 2Linked to original sources

PubMed1991

[Univentricular heart: angiographic features in 31 patients].

PURPOSE: Evaluation of angiographic features of univentricular heart. METHODS: Thirty-one patients were divided into 3 groups according to morphological type of univentricular heart: left ventricle type, right ventricle type and undetermined. They were studied for atrio-ventricular junction, position of rudimentary chamber in relation to principal chamber, ventricle-arterial junction, the position of the two great arteries in relation to each other and whenever possible, the origin of the coronary arteries. RESULTS: There were 16 cases of left ventricle type with A-V junction through 2 valves in 8 and through single valve in 6. The rudimentary chamber position was superior and to the right in 4 cases of dextrocardia and superior and to the left in 8 of levocardia. The ventricle-arterial junction was discordant in 9 patients and concordant in 4, double outlet of rudimentary chamber in 2 and single outlet in 1. The aorta was anterior to the pulmonary artery in 13 patients. Anomalous origin of the coronary arteries occurred in 5 of 9 cases studied. Right ventricle type occurred in 9 patients with absence of one of the A-V junctions in 5. Trabecular pouch was seen in 6 patients, posterior and inferior positioned in all of them. Double outlet from principal chamber occurred in 8 patients. The aorta was anterior in 66.6%. Undetermined type occurred in 6 patients with A-V junction through single valve in 5. In 3 there was double outlet from principal chamber showing pulmonary stenosis and in the remaining 3 there was pulmonary atresia. CONCLUSION: Discordant ventricle-arterial junction is common for left ventricle type; trabecular pouch is frequent in right ventricle type; single A-V valve is common for undetermined type; obstruction of pulmonary flow happens in all 3 types but it is more frequent in undetermined type; the aorta is anterior to the pulmonary artery in most cases; it is common the anomalous origin of the coronary arteries from the aortic sinus.

Adolescent↗

PubMed1991

[Cardiac rhabdomyomas].

Case report of cardiac rhabdomyoma in one two days old infant with important cyanosis and respiratory insufficiency with evolution to death in few hours. The radiologic feature was a great enlargement of the heart and the electrocardiographic study showed left branch block. The two-dimensional echocardiography study showed multiple intracavitary tumours in both ventricles and in the right atrium. These features were confirmed in the post-mortem study. The microscopic study of the tumors showed proliferation of the spider cells, and vacuolation with the presence glycogen. The diagnosis of cardiac rhabdomyoma was confirmed. The brain and the kidney were not studied for the diagnosis of tuberous sclerosis or kidney tumors. It is very important the early diagnosis by echocardiography, due to the possibility of surgical resection of the intracavitary tumors that cause severe obstruction to the blood flow.

Echocardiography↗

PubMed1990

[Traumatic ventricular septal defect. A case report].

A 34 years old woman, without previous cardiac symptoms, suffered a closed thoracic trauma in a car accident. Three days after presented dyspnea and orthopnea. Physical examination revealed a systolic murmur consistent with ventricular septal defect (VSD). Doppler echocardiography and angiography confirmed the presence of a muscular VSD with severe left-to-right shunt. Surgical intervention was indicated and VSD closure was performed with a patch, through a right atrium approach. Third degree atrioventricular block developed after surgery and a definitive pacemaker was implanted. The patient is asymptomatic and without murmurs in postoperative follow-up.

Accidents, Traffic↗

PubMed1989

Clinical and laboratory signs of reperfusion: are they reliable?

We studied 101 patients (88 men and 13 women, mean age 54.5 +/- 10 years) who arrived at the hospital during the first 6 hours of acute myocardial infarction evolution. Our objective was to assess the reliability of clinical and laboratory signs of recanalization using intravenous streptokinase as a thrombolytic agent. The mean time between the beginning of infusion and coronary arteriography was 53.83 +/- 43 hours. The positive predictive values for pain, arrhythmia, ST segment and enzymes were 97.9%, 94.2%, 91.8% and 90.8%, respectively; the negative predictive values were 46.8%, 40.8%, 37.2%, and 50% in the same order. Sensitivity was 65.7%, 62.8%, 58.4% and 77.6% and specificity 95.6%, 86.9%, 82.6% and 73.9%, respectively. The positive predictive value, calculated on the basis of the presence of each variable alone or in association showed a probability of recanalization of 76.9% for one sign, 84% for two, 96.3% for three and 100% for all four. When we compared the positive predictive values of each variable according to the interval between the beginning of pain and admission to the hospital (during the first 3 hours or between 3 and 6 hours) our results were 100%/94% for pain (P = NS), 97%/88% for arrhythmia (P = NS), 100%/75% for ST segment (P = 0.004), and 97%/80% for enzymes (P = 0.019). The same analysis applied to negative predictive values showing 22%/62% (P = 0.007), 17%/55% (P = 0.008), 21%/47% (P = NS), 27%/61% (P = NS) for pain, arrhythmia, ST segment and enzymes, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

[Myocarditis simulating acute myocardial infarction. A case report].

A six month-old infant presenting congestive heart failure and electrocardiographic features of acute myocardial infarction, including increased CK-MB levels. The echocardiographic study showed normal origin of the coronary arteries and features compatible with myocardiopathy. After good early response to conventional therapy, the patient developed severe congestive heart failure and shock, and died. In the post-mortem study, the coronary arteries were previous. Microscopic study was compatible with acute myocarditis.

Creatine Kinase↗

PubMed1989

[Pulmonary artery aneurysm. Report of 2 cases].

The clinical suspicion of pulmonary artery aneurysm was made in two patients from the clinical signs and radiographic features. The echocardiographic studies showed features concerned with this pathology, and hemodynamic studies confirmed the diagnosis by pulmonary angiography. Both patients presented pulmonary valve insufficiency due to the huge pulmonary artery and dilatation of the valvular annulus. Other congenital malformations of the heart and pulmonary hypertension were not present in these patients. Surgical treatment was indicated in both patients. Surgery in patient no. 2 consisted of resection of the main pulmonary artery aneurysm and replacement with a valved conduit bovine pericardium and anastomosed with a patch of bovine pericardium connecting the left and right pulmonary arteries. The postoperative period was uneventful.

Aneurysm↗

PubMed1989

[Ebstein's anomaly of the mitral valve. A very unusual congenital malformation of the heart. A case report].

Ebstein anomaly of the tricuspid valve is a well known malformation of the heart, but this occurrence in the mitral valve is a very rare congenital heart disease. In this case report a two years and nine months old girl with symptoms of heart failure during the first year of life due to severe mitral regurgitation was studied. The echocardiographic and angiographic features were typical of the Ebstein malformation of the mitral valve. The surgical treatment was made with implantation of pericardial bovine bioprothesis in the mitral position, without ressection of the natural valve tissue. The surgical features confirmed the diagnosis and the postoperative evolvement is excellent.

Bioprosthesis↗

PubMed1988