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Biomedical subjects

C Z Naggar

Publications and source records attributed to C Z Naggar.

At least 19 recordsLinked to original sources
PubMed1991

Doppler echocardiographic assessment of prosthetic aortic valve function. Findings in normal valves.

To determine the Doppler-derived aortic flow velocity profiles in relation to type of prosthetic valve and left ventricular function, 70 patients with normal functioning aortic prosthetic valves (group 1 = 44 patients with low-profile mechanical valves and group 2 = 26 patients with high-profile mechanical valves) were evaluated. Peak flow velocity and mean systolic gradient were inversely related to valve size (r = -0.72; r = -0.76) in group 1. On the other hand, aortic flow velocity profiles had significant correlations with left ventricular end-systolic dimension (r = 0.75; r = 0.76) and left ventricular fractional shortening (r = -0.69; r = -0.66) in group 2. Thus, aortic flow velocity profiles in the low-profile mechanical valve were affected by pressure gradient caused by the valve size, whereas the hydromechanical disadvantage of the high profile mechanical valve affected the left ventricular pump function and Doppler-derived flow velocity profiles.

Aortic Valve↗
PubMed1987

Successful medical management of esophagopericardial fistula.

Esophagopericardial fistula is a rare condition, usually presenting with cardiac tamponade, and is invariably fatal in the adult patient. In our patient the disorder resulted from fistulization secondary to a malignant tumor. Immediate decompression of resultant tense pneumopericardium can be accomplished safely through percutaneous pericardiocentesis without the need for surgery. Rarely, as in the present case, spontaneous closure of esophagopericardial fistula is encountered.

Esophageal Fistula↗
PubMed1986

Frequency of complications of mitral valve prolapse in subjects aged 60 years and older.

One hundred forty-five patients (74 women, 71 men), aged 60 years and older, with echocardiographically documented mitral valve prolapse were studied. One hundred sixteen patients had precordial systolic murmurs, 20 of whom were suspected of having mitral valve prolapse before the echocardiographic study. Infective endocarditis occurred in 7 patients, cerebral ischemic events in 13 and spontaneous rupture of chordae tendineae in 33. Four other patients had ruptured chordae tendineae associated with infective endocarditis. Congestive heart failure was present in 35 patients, 11 of whom had undergone mitral valve surgery.

Aged↗
PubMed1986

Rapid amyloid infiltration of the heart.

In a 63-year-old patient, echocardiography on initial evaluation showed normal left ventricular function and dimensions and seven months later revealed characteristic amyloid infiltration pattern associated with symptoms of congestive heart failure. Normal left ventricular hemodynamics had changed to a classic restrictive physiology associated with elevated ventricular diastolic pressures. Amyloid deposition was documented by endomyocardial right ventricular biopsy. The rapidity with which cardiac amyloid deposition can occur was demonstrated.

Amyloidosis↗
PubMed1986

Clinician's approach to echocardiography.

Today, echocardiography enjoys a prominent place in the physician's diagnostic armamentarium. Its safe application, accuracy, and reproducibility have made its widespread use popular. The ability of echocardiography to visualize cardiac valves, intracardiac masses, and ventricular wall motion is unique. This article highlights the applications of echocardiography from the physician's vantage point.

Diagnosis, Differential↗
PubMed1986

Infective endocarditis: a challenging disease.

Enhanced clinical awareness of infective endocarditis, along with improved microbiologic methodology and more aggressive surgical intervention, has favorably influenced the outcome of the disease. The evolving nature of infective endocarditis over the past decade is described, as are the changing epidemiologic factors, microbiologic techniques, and echocardiographic contributions in the clinical management of patients with infective endocarditis.

Adult↗
PubMed1985

Echocardiographic manifestations of tense pericardial effusion.

Echocardiography has emerged as a sensitive study in the evaluation of pericardial effusion. The specificity of echocardiographic signs in cardiac tamponade remains undefined, however. Two such signs, early diastolic collapse of the right ventricular free wall and late diastolic collapse of the right atrial wall, were observed in two patients without clinical evidence of cardiac tamponade. Increased intrapericardial pressure was documented in each patient. Accumulation of pericardial fluid under high pressure results in a reversal of the instantaneous transmural pressure gradients in early and late diastole, causing collapse of the right ventricular and the right atrial wall, respectively; however, such a tense pericardial effusion may not cause hemodynamic embarrassment severe enough to yield clinical signs of cardiac tamponade.

Adult↗
PubMed1984

Two-dimensional echocardiography. Viewing the heart in motion.

The accuracy and safety of two-dimensional echocardiography and the reproducibility of findings have led to its current prominence in the physician's diagnostic armamentarium. It has wide clinical applications, excelling in assessment of valvular heart disease, pericardial effusion, and intracavitary masses, such as vegetations and left ventricular clots. In addition, it is useful in differentiating types of cardiomyopathy and in evaluating global left ventricular systolic function. This article highlights the clinical applications of two-dimensional echocardiography, which is easily the most complete anatomic study of the beating heart.

Diagnosis, Differential↗
PubMed1982

Effects of amyl nitrite on left ventricular relaxation in patients with borderline hypertension.

The effects of systemic hypertension on left ventricular relaxation properties remain largely undefined. To assess such effects 22 normal volunteers and 15 patients with borderline hypertension were examined. The tangent to the echocardiographic left ventricular posterior wall endocardium was measured in diastole and was normalized for end-diastolic dimension to yield normalized velocity of relaxation. This velocity of relaxation was measured at rest and throughout inhalation of amyl nitrite. Mean value +/- standard deviation (SD) from rest to peak amyl nitrite effect for the normal group and for the patients with borderline hypertension was 3.3 +/- 0.6 leads to 7.2 +/- 1.1 and 3.0 +/- 0.8 leads to 4.4 +/- 1.1 s-1, respectively. All 22 persons in the normal group and 2 of the 15 patients with borderline hypertension attained normalized velocity of relaxation greater than 5.5 s-1 with administration of amyl nitrite. Multivariate analysis in the normal group identified heart rate, mean arterial pressure, and fractional shortening as the best predictors of normalized left ventricular relaxation velocity (r = 0.85; p less than 0.001). The increase in the normalized velocity of relaxation induced by amyl nitrite is blunted in patients with borderline hypertension. These changes in left ventricular relaxation identify early cardiac involvement and may prove clinically useful in hypertensive patients.

Adult↗
PubMed1980

Dysphagia due to aortic arch anomaly: diagnostic and therapeutic considerations.

An unusual aortic arch anomaly produced dysphagia in a previously healthy man. Aortography performed simultaneously with a barium esophagogram disclosed a right aortic arch and right descending aorta. Esophageal compression was caused by a retroesophageal aortic diverticulum that emerged from the descending aorta and gave rise to the left subclavian artery. A left ligamentum arteriosum connected the proximal left subclavian artery and the left pulmonary artery, thus completing a vascular ring encircling the esophagus. Surgical correction was accomplished using a left thoracotomy. Division of the ligamentum as well as the junction of the aortic diverticulum and left subclavian artery freed the esophagus from its circumferential constrictions and relieved the patient's dysphagia.

Adult↗
PubMed1979

Echocardiography: a diagnostic plus.

Echocardiography adds a new dimension to diagnosis of cardiac disorders. This safe, noninvasive technique aids in the differential diagnosis of systolic murmur, chest pain, and cardiomegaly, in the etiologic diagnosis of mitral regurgitation and atrial fibrillation, and in assessing left ventricular function.

Angina Pectoris↗
PubMed1978

Spontaneous near closure of coronary artery fistula.

An asymptomatic 14-year-old male was found at cardiac catheterization to have a coronary artery fistula involving a vessel originating from the left main coronary artery and terminating in the right heart. Chest X-ray and electrocardiogram were within normal limits and shunt flow was too small to be detected by oximetry although a large vessel was seen angiographically. One year later, the previously loud continuous murmur had disappeared and repeat catheterization demonstrated near closure of the fistula. This is the first report documenting the spontaneous closure of a coronary artery fistula.

Adolescent↗