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Biomedical subjects

A Purcaro

Publications and source records attributed to A Purcaro.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Echocardiographic and clinical correlations in infectious endocarditis of the left heart].

UNLABELLED: The echocardiographic features were correlated with the clinical findings and outcome in 35 patients with aortic and/or mitral valve endocarditis. There were 26 males and 9 females with a mean age of 38 years. The infection involved native valves in 27 patients and prosthetic valves in 8 patients. Echocardiographically, fourteen patients had involvement of native aortic valve. All patients in this group required surgical intervention, nine patients during antimicrobial therapy. Congestive heart failure was the clinical indication for valvular replacement. A patient died immediately after surgery from low cardiac output syndrome. Six patients had echocardiographic evidence of aortic and mitral valves involvement. A patient in this group expired before surgery, five underwent surgery because of progressive heart failure (aortic or aortic and mitral valves replacement). Seven patients showed lesions on native mitral valve (6 in this group had prolapse syndrome). A patient died from cerebrovascular embolus, two underwent surgery because of persistent infection and embolic events, four were successfully treated with medical therapy. Among patients with prosthetic valve endocarditis, four showed signs of valvular dehiscence and required surgical intervention, during antimicrobial therapy, from congestive heart failure; one patient expired from recurrent infection. The pathological findings correlated well with echocardiographic findings. CONCLUSIONS: in IE the localization of lesions by echo has prognostic significance: most patients with aortic valve or aortic and mitral valves endocarditis require early surgical intervention because of congestive heart failure. On the contrary, mitral valve involvement carries a better prognosis, requiring less frequently valvular replacement; the patients with echocardiographic signs of prosthetic valve dehiscence require urgent intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

[Comparison of the anti-arrhythmic effects of propafenone and aprindine in the treatment of refractory chronic ventricular arrhythmias. A randomized double-blind crossover study controlled with placebo].

A placebo-controlled, randomized, double-blind, crossover study was performed in 14 patients with chronic, resistant, ventricular arrhythmias in order to evaluate the efficacy and safety of two new antiarrhythmic agents, propafenone and aprindine. After an initial placebo phase, patients received orally either propafenone (600 mg daily) or aprindine (150 mg daily for the first two days and 50 mg every 12 hours successively) for five days. This treatment was followed by a drug-free period (placebo II); patients were then crossed over to the alternative drug. A 24-hour Holter recording was performed during the last 48 hours of the initial placebo phase and on the final day of each phase of the crossover period. Analysis of Holter recordings revealed that the mean hourly PVCs frequency, for the group, was similar during the two control periods. Significant reduction in the mean hourly frequency of PVCs from control levels was observed in 78% of the patients during propafenone therapy and in 42% during aprindine therapy. For the whole group, propafenone induced a significant reduction of the average PVCs/h frequency (p less than 0.05), whereas the aprindine was ineffective. Finally no patient experienced side effects with propafenone, whereas aprindine caused side effects in three patients (dizziness, tremor, ataxy).

Adult↗
PubMed1982

[Echocardiographic diagnosis of aneurysm of Valsalva's sinus with fistulization into the right atrium].

The preoperative diagnosis of an aneurysm of the posterior sinus of Valsalva with rupture into the right atrium was made by echocardiography in a 21-year-old patient. The M-mode echocardiography revealed the following findings: 1) a vibrating anomalous structure, continuous with the aortic wall, was present in the right atrium. The echo-producing mass was the wall of the aneurysm, which adhered to the septal leaflet of the tricuspid valve during early-to-mid systole and had an abrupt posterior motion in late systole. In diastole, the wall of the aneurysm descended into the tricuspid orifice and its motion was similar to that of the septal leaflet of the tricuspid valve; 2) an echocardiographic sweep from the aorta to the left ventricle showed that the posterior wall of the aorta "crossed" the mitral orifice; 3) the pulmonic and tricuspid valves were normal. The 2-D echocardiographic findings gave support to the M-mode diagnosis: 1) in the short-axis view (at the level of the aorta) two lines of echoes came off the right side of the aortic wall and invaded the right atrium. These echoes were produced by the walls of the aneurysm; 2) in the apical four-chamber view the aneurysm descended into the tricuspid orifice in diastole, whereas it was lifted by the septal leaflet of the tricuspid valve in systole. The aneurysm appeared as vibrating lump on the closed tricuspid valve. Recognition of these features provides a potential non-invasive way to diagnose this anomaly. To our knowledge this is the first description of the characteristic echocardiografic picture of an aneurysm of the sinus of Valsalva with rupture into the right atrium.

Adult↗
PubMed1981

[Aneurysm of the membranous septum associated with interventricular patency. Echocardiographic study].

It has been documented by others that spontaneous closure or diminution in size of membranous ventricular septal defect is often associated with aneurysmal formation of the membranous septum. In a series of 51 patients, who underwent cardiac catheterization and cineangiocardiography for evaluation of the severity of a ventricular septal defect, 7 patients showed an aneurysm of the membranous interventricular septum (VSA) associated with a small ventricular septal defect (VSD). M-mode echocardiography was useful in the detection of VSA in 6 of them. Echocardiographic findings were not uniform in all cases. In most instances they consisted of linear echoes, that seemed to come off from the base of the interventricular septum and to protrude within the right ventricle in systole; the echoes from the VSA showed a coarse fluttering. Even if errors can be minimized by a correct technique, anomalous echoes from the VSA might however be confused with those of other anatomical structures (aortic root, tricuspid valve, etc.). M-mode echocardiography seems to be useful for the followup of patients with membranous VSD. The detection of VSA by ultrasonic means should suggest a good prognosis for VSD, possibly avoiding the need for repeat invasive studies.

Adolescent↗
PubMed1979

[Congestive heart failure in genetic hypertrophic cardiomyopathies (ASH) (author's transl)].

Of a total sixtytwo patients covering all the spectrum of genetic ASH, who were studied by heart catheterization, M-mode echocardiography and phonomechano cardiography, five patients (four with the obstructive variety of the disease) showed clinical evidence of chronic congestive heart failure with ankle edema and hepatomegaly (group I). Their data were compared with those of fifteen "obstructed" patients who were not in heart decompensation (group II). No statistically significant differences were found between groups I and II in terms of L.V. internal transverse dimensions and in terms of L.V. systolic function. Conversely a statistically significant difference was found between the two groups in terms of left atrial and right ventricular dimensions (P less than 0,001), which were markedly increased in groups I. These findings strongly suggest that in patients with ASH and congestive heart failure there is a reduction in L.V. compliance (or distensibility), whereas L.V. systolic function is essentially preserved. The persistence of severe L.V. outflow obstruction in four patients of I group gives further confirmation to these observations. The use of beta-blockers (in association or not with cardiac glycosides) seems therefore to preserve its validity in the treatment of patients with ASH and heart failure, particulary when severe L.V. outflow obstruction is present. Cardiac glycosides are indicated in the forms with little or no obstruction to L.V. ejection.

Adult↗
PubMed1979

[The tricuspid valve prolapse. Clinical significance and diagnostic problems (author's transl)].

Systolic prolapse of the tricuspid valve is a relatively unknown anatomo-clinical entity. In this communication etiology, clinical significance and diagnostic problems of this condition are reported and discussed. The frequent association with mitral valve prolapse and the coexistence of skeletal and cardiac anomalies strongly suggest the role of congenital factors and the degenerative nature of this valvular abnormality. Pathophysiology of leaflets prolapse remains unexplained for those few reported cases of isolated tricuspid invovlement. The clinical diagnosis of tricuspid valve prolapse is difficult, since the characteristic physical signs of tricuspid incompetence are uncommon, while apical mid-systolic click-late systolic murmur may indicate mitral valve prolapse, tricuspid valve prolapse, or a combination of the two. In the reported cases selective right ventriculography (R.A.O.) has shown pansystolic or late systolic prolapse of anterior and inferior leaflets (without or with varying degree of tricuspid incompetence) or isolated late systolic prolapse of the inferior cusp. M-mode echocardiography has shown great value in the diagnosis of tricuspid valve prolapse. On the echocardiogram several types of abnormalities have been noted which correlated well to angiocardiographic data. Tricuspid valve prolapse is of clinical importance, since this condition may be associated with significant tricuspid incompetence, a high incidence of cardiac arrhythmias, and possibly with bacterial endocarditis.

Adolescent↗
PubMed1979

[Echocardiographic patterns of congenital aneurysm of the sinus of Valsalva. Review of literature and report of three cases (author's transl)].

The (M-mode) echocardiographic patterns of three patients with congenital aneurysm of the right sinus of Valsalva are reported. In two patients the aneurysm ruptured into the right ventricular cavity. In the third case, in which the lesion was associated with coarctation of the aorta, no communication was shown between the aorta and other cardiac chambers. The characteristic echocardiographic features of the right coronary sinus aneurysm (either with or without rupture in the right ventricular cavity) consist of: 1) The presence of echoes (referable to the right aortic cusp pattern of motion) encroaching the right ventricular outflow tract. 2) The presence of the same box-shaped echoes at a low level of the left ventricular cavity, which seem to "cross" the septum (from the left to the right ventricular outflow tract). These images would reflect the "prolapse" of the affected cusp. Other common, but non-specific echocardiographic features of the lesion are: an indistinct contour of the anterior wall of the aortic root (probably due to dilatation of the right coronary sinus) and systolic indentations on the right anterior aortic cusp echoes.

Adult↗
PubMed1976

[Horseshoe lung, cardiac malposition and pulmonary vascular anomalies: a characteristic syndrome (author's transl)].

The clinical, radiological, haemodynamic and angiocardiographic features of a very rare anatomo-clinical entity (i.e. the horseshoe lung), associated with heart malposition and anomalies of the venous and arterial pulmonary vasculature are reported. The horseshoe lung is a pulmonary malformation which essentially consists of partial fusion of the lungs behind the pericardial sack. Of this entity only two cases have been previously reported in the literature, in which the diagnosis was made at necropsy. The reported case is the first in which the diagnosis was made in a living patient. The essential characteristic considered pathognomonic of the syndrome are described.

Cardiac Catheterization↗
PubMed1976

[Echocardiographic diagnosis of the dissection of the thoracic aorta].

Nine patients with aortic root dilatation without dissection and four patients with a dissecting aneurysm of the ascending aorta were studied with single-plane echocardiography. Previously reported echocardiographic findings, which have been shown to be similar in these two groups of patients, are confirmed. In addition to (a) aortic root dilatation, (b) thickening of the anterior and/or the posterior aortic wall, and (c) the multiple parallel echoes within the widened aortic walls, which are all considered to be not specific signs of dissection, the authors outline the presence of some specific echocardiographic patterns in patients with a dissecting hematoma of the ascending aorta. These include: 1) the loss of contiguity between the inner borders of the anterior aortic wall and the interventricular septum when the dissection is confined to the anterior wall of the aorta; 2) the loss of contiguity between the inner and/or outer borders of the posterior aortic wall and the mitral anulus if the hematoma extends to the posterior wall of the aorta.

Adult↗
PubMed1975

[The association between primitive pulmonary hypertension and essential systemic arterial hypertension. Remarks on two personal observations (author's transl)].

The clinical, laboratory, haemodynamic, cardioangiographic and anatomo-pathological features are described in two patients in whom the association of "Primary Pulmonary Hypertension and Arterial Essential Systemic Hypertension" was noticed. On the basis of a hyperactive neurohormonal mechanism, a hypothetical, ethiological relationship between the pure hypertensive state of both the circulations is discussed. The occurrence of hypertensive systemic episodes and Raynard's phenomena lend weight to the hypothesis that neurohormonal mechanisms might participate in the pathophysiology of this syndrome.

Biopsy↗