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Biomedical subjects

David H Hsi

Publications and source records attributed to David H Hsi.

5 recordsLinked to original sources

Hypertrophic cardiomyopathy and symptomatic conduction system disease in cardiac amyloidosis.

Cardiac involvement is the most important prognostic factor in primary amyloidosis (AL). The clinical presentation of amyloid cardiomyopathy is varied and may manifest as heart failure, brady or tachyarrhythmias, syncope, angina and rarely with features of hypertrophic cardiomyopathy and advanced symptomatic conduction system disease. The management of amyloid cardiomyopathy has always been a dilemma, as most of the drugs used in congestive heart failure are contraindicated. This report describes a 70-year-old woman who presented with syncope, severe diastolic heart failure, features of hypertrophic cardiomyopathy and severe symptomatic conduction system disease requiring a pacemaker. Amyloidosis was diagnosed on endomyocardial biopsy after abdominal fat aspirate was negative for amyloid. The patient eventually expired due to end-stage congestive heart failure.

Aged↗

Large aneurysms of the ascending aorta and major coronary arteries in a patient with hereditary hemorrhagic telangiectasia.

We describe a 50-year-old man with a history of hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) who presented with chest pain, atrial fibrillation, and congestive heart failure. Echocardiography revealed a large ascending aortic aneurysm accompanied by severe aortic regurgitation and giant coronary artery aneurysms involving the right, left main, left anterior descending, and circumflex coronary arteries. Coronary angiography clearly defined multiple aneurysms involving the aorta and coronary arteries. The patient underwent complex and successful surgical repair of the aneurysms. To our knowledge, this is the first reported case of extensive cardiac involvement in a patient with this uncommon genetic disorder.

Aortic Aneurysm, Thoracic↗

A 29-year-old Harken disk mitral valve: long-term follow-up by echocardiographic and cineradiographic imaging.

An 81-year-old woman was evaluated for prosthetic mitral valve function. She had received a Harken disk mitral valve 29 years earlier due to severe mitral valve disease. This particular valve prosthesis is known for premature disk edge wear and erosion. The patients 2-dimensional Doppler echocardiogram showed the distinctive appearance of a disk mitral valve prosthesis. Color Doppler in diastole showed a unique crown appearance, with initial flow acceleration around the disk followed by convergence to laminar flow in the left ventricle. Cineradiographic imaging revealed normal valve function and minimal disk erosion. We believe this to be the longest reported follow-up of a surviving patient with a rare Harken disk valve. We present images with unique echocardiographic and cineangiographic features.

Aged↗