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Biomedical subjects

L E Teichholz

Publications and source records attributed to L E Teichholz.

At least 19 recordsLinked to original sources
PubMed1979

Prognostic value of echocardiographic evaluation of septal function in acute anteroseptal myocardial infarction.

To determine the clinical usefulness of echocardiography in patients with anteroseptal myocardial infarction, echocardiograms were performed within 24 hours of admission on 40 patients with acute transmural anteroseptal myocardial infarction. Twenty-one patients had normal septal motion and septal systolic thickening, and 19 patients had abnormalities of one or both of these measurements. Of the 21 patients who had normal septal motion and thickening, only five developed congestive heart failure, none developed bundle branch block, and none died. Of the 19 patients with abnormal septal motion and/or thickening, 17 developed congestive heart failure (p less than .001), seven developed bundle branch block (p less than .001), and six died (p less than .001). Therefore, (1) electrocardiographic evidence of septal infarction does not correlate with abnormalities of the portion of septum seen on echocardiogram, and (2) patients with anteroseptal myocardial infarction and abnormalities of the septum on echocardiogram have more complications and a higher in-hospital mortality rate. These patients may have more extensive myocardial infarction predisposing to pump failure and possibly involving the conduction system.

Aged↗
PubMed1979

The influence of left ventricular late diastolic filling on the A wave of the left ventricular pressure trace.

To study the influence of left ventricular (LV) late diastolic filling on the A wave of the LV pressure, simultaneously recorded echocardiographic LV dimensions and high-fidelity LV pressure measurements were taken in 24 patients. Group 1 comprised eight patients without LV hypertrophy (LVH) and LV end-diastolic pressure (LVEDP) less than or equal to 13 mm Hg. Group 2 comprised 16 patients with LVH secondary to aortic stenosis, idiopathic hypertrophic subaortic stenosis, or hypertension and increased LVEDP. Patients in group 2 had significantly thicker left ventricles, decreased mitral E-to-F slopes, and larger A waves in the LV pressure curve. On the basis of end-diastolic chamber stiffness, we divided group 2 into two populations: 12 patients (group 2A) with end-diastolic chamber stiffness similar to that in group 1, and four patients (group 2B) with markedly elevated end-diastolic chamber stiffness. Patients in group 2A had a larger atrial contribution to LV filling than those with markedly abnormal stiffness (group 2B). Therefore, in LVH an increased A wave in the LV pressure may be related to either elevated end-diastolic chamber stiffness or augmented left atrial volume transport.

Adult↗
PubMed1978

Systolic anterior motion of the tricuspid valve in idiopathic hypertrophic subaortic stenosis.

A 37 year man with combined subpulmonic and subaortic idiopathic hypertrophic stenosis proved by cardiac catheterization had typical echocardiographic findings of idiopathic hypertropic subaortic stenosis (IHSS) and systolic anterior motion of the anterior leaflet of the tricuspid valve. This motion of the tricuspid valve may relate to the subpulmonic infundibular gradient in the same way that the systolic anterior motion of the anterior mitral leaflet relates to the subaortic left ventricular gradient in patients with IHSS.

Adult↗
PubMed1978

The ventricular A wave: a new echocardiographic index of late diastolic filling of the left ventricle.

Echocardiography was used to evaluate the late diastolic filling period of the left ventricle in 30 normal individuals, 25 patients with left ventricular hypertrophy, normal sinus rhythm, and either a normal or delayed mitral valve closure, and 15 patients with atrial fibrillation. The echocardiographic ventricular A wave (VAW) was defined as the difference between the end-diastolic and an earlier late-diastolic internal left ventricular dimension, and it was felt to primarily reflect the atrial contribution to late diastolic filling of the left ventricle. It disappeared during ventricular pacing and was significantly smaller than normal in patients with atrial fibrillation. The VAW was significantly larger in patients with left ventricular hypertrophy and normal mitral valve closure reflecting the greater contribution by atrial contraction to late diastolic filling in these patients. In patients with left ventricular hypertrophy and delayed mitral valve closure, the VAW was normal reflecting lesser ventricular enlargement with atrial contraction than in the other patients with left ventricular hypertrophy. This suggested a greater impairment to left ventricular filling in these patients. Therefore, the VAW appears to be an indicator of abnormalities of late diastolic filling caused by left ventricular hypertrophy.

Adult↗
PubMed1977

Echocardiographic diagnosis of left anterior descending coronary artery disease.

To determine the usefulness of the standard echocardiogram in the diagnosis of left anterior descending coronary artery disease proximal or distal to the first septal branch, coronary arteriograms and echocardiograms were performed in 77 patients with a chest pain syndrome. Seventy-nine percent of patients with proximal disease (15 of 19) had an abnormal septal motion measured as a posterior wall/interventricular septal (PW/IVS) excursion ratio greater than or equal to 2.5 compared with 10% of patients with distal disease (2 of 20) who had abnormal septal motion. Only 5% of patients without obstructive disease of the left anterior descending coronary artery (2 of 38) had abnormal septal motion. Proximal disease was found in 79% with abnormal septal motion in the echocardiogram (15 of 19) but in only 7% of patients with normal septal motion (4 of 58). Therefore, abnormal septal motion as measured by the PW/IVS excursion ratio in the echocardiogram is a useful index for the diagnosis of disease of the left anterior descending coronary artery when that disease is proximal to the first septal branch.

Adult↗
PubMed1977

Septal perforator compression (narrowing) in idiopathic hypertrophic subaortic stenosis.

Thirteen patients with idiopathic hypertrophic subaortic stenosis were compared with two groups of subjects: 10 patients with chest pain, normal coronary arteries and a normal left ventricle, and 10 patients with left ventricular hypertrophy. Five of the latter had aortic stenosis and five had idiopathic left ventricular hypertrophy. Coronary arteriography revealed that the septal branches of the left anterior descending artery closed or narrowed during systole in patients with idiopathic hypertrophic subaortic stenosis and did not do so in the other patient groups. This narrowing is possibly related to an abnormal position of the septal arteries within the septum in idiopathic hypertrophic subaortic stenosis. Systolic compression of the septal perforator arteries is not a pathognomonic sign of idiopathic hypertrophic subaortic stenosis.

Aged↗
PubMed1977

Left ventricular myxoma: echocardiographic diagnosis and review of the literature.

A 33 year old man with the findings of mild aortic stenosis had an echocardiographic diagnosis of left ventricular myxoma prolapsing through the aortic valve during each ventricular systole. The M-mode echocardiogram, B-scan ultrasonogram and angiograms of this patient are presented. The clinical characteristics in all the reported cases of left ventricular myxomas are reviewed.

Adult↗
PubMed1977

Mitral valve prolapse: a review of associated arrhythmias.

The syndrome of mitral valve prolapse with associated auscultatory-electrocardiographic findings is now well documented. Two representative cases of repetitive tachyarrhythmias in patients with mitral valve prolapse are discussed as well as an analysis of the 589 cases in the English literature of arrhythmias in patients with mitral valve prolapse. The average age of the patients was 38 years; 70 per cent of them were women. Symptoms were variable, but palpitations occurred in 44 per cent, lightheadedness in 12 per cent and syncope in 4 per cent. Premature atrial and/or ventricular contractions were found in 55 per cent, premature ventricular contractions in 45 per cent, supraventricular tachycardia in 6.1 per cent and ventricular tachycardia in 6.3 per cent. Sudden death was noted in 1.4 per cent. A discussion of the pathogenesis of arrhythmias and therapy concludes this review.

Adolescent↗
PubMed1977

Correlations of electrocardiography and echocardiography in determination of left ventricular wall thickness: Study of apparently normal subjects.

To examine the usefulness of the surface electrocardiogram in predicting left ventricular wall thickness as determined with echocardiography, standard echocardiograms, electrocardiograms and Frank lead vectorcardiograms were obtained in 30 volunteers. End-diastolic thickness of the interventricular septum and free posterior wall was measured from the echocardiogram and compared with the sum of the S wave in lead V1 plus the R wave in lead V6 (VS1+R6) and the magnitude of the Frank lead vector (Vf), a scalar dunction obtained from a simple analog device. The maximum of Vf, the summated vector (Vf), was highly correlated with VS1+R6 (r=0.84). There was significant correlation between the summated vector and VS1+R6 and the thickness of the interventricular septum (IVS) (r=0.73 and 0.66, respectively). The best least mean square fit for the population was Vf=1.7 IVS-0.39. There was no significant correlation between these variables and the end-diastolic thickness of the posterior wall. Volunteers who were athletically inclined or were joggers tended to have larger summated vector values and evidence of symmetric or asymmetric left ventricular hypertrophy in the echocardiogram. It therefore appears that the thickness of the interventricular septum has a greater influence on the summated vector and VS1+R6 that the echocardiographically assessed thickness of the free posterior wall of the left ventricle. The implications of these findings in the light of recent reports about the incidence of echocardiographically diagnosed left ventricular hypertrophy are discussed.

Adult↗
PubMed1977

The normal electrocardiogram as a predictor of left ventricular function in patients with coronary artery disease.

Fifty-five consecutive patients with a normal resting electrocardiogram and coronary artery disease were examined to determine left ventricular function. Fifty-two (95%) had no evidence of left ventricular asynergy; 3 patients had only mild hypokinesis. Of this group of patients, 25 (47%) had one vessel disease, 17 (30%) had two vessel disease, and 13 (23%) had three vessel disease. Significant left ventricular asynergy was not found in patients with coronary artery disease and normal electrocardiograms. In addition, a normal electrocardiogram was not related to the number of coronary arteries involved.

Adult↗
PubMed1977

Pericardial tumor of fibrosis mimicking pericardial effusion by echocardiography.

Echocardiograms of three patients with metastatic carcinoma or lymphoma showed a sonolucent space posterior to the left ventricular epicardium, as seen in pericardial effusion. However, at surgery or autopsy no pericardial fluid was found. Instead, the pericardium was infiltrated by neoplastic tissue or fibrosis. In view of this finding, we suggest caution in the interpretation of "positive" echocardiograms for pericardial effusion in patients with neoplastic disease, especially if pericardiocentesis is being considered.

Adenocarcinoma↗
PubMed1976

Dermatoglyphic patterns in patients with mitral valve prolapse: a clue to pathogenesis.

Fingerprints were obtained from 100 patients with mitral valve prolapse and compared with those of 100 control subjects matched for sex and race. Arches were found in 16.8 percent of all digital patterns in patients with mitral valve prolapse but in only 2.5 percent of all digits in the control group. Whereas no patient in the control group had four or more arches, 19 percent of patients with mitral valve prolapse had this finding. In addition, arches were found on 16 and 9 percent, respectively, of digits IV and V in patients with mitral valve prolapse but were not found on these digits in the control group. The finding of four or more arches or arches on digits IV or V may be important supportive evidence of mitral valve prolapse when evaluating patients with atypical chest pain and palpitations. Antenatal factors may be involved in the pathogenesis of mitral valve prolapse since it is possible that a genetic or environmental factor that interferes with the development of the mitral valve may also influence epidermal ridge patterns.

Analysis of Variance↗
PubMed1976

Paradoxical motion of the interventricular septum with right ventricular dilatation in the absence of shunting: report of two cases.

A history, heart murmur, electrocardiogram and chest X-ray film suggesting an atrial septal defect associated with an echocardiogram revealing paradoxical motion of the interventricular septum with a dilated right ventricle may be considered indicative of a secundum or primum defect in a young adult or child. Two patients who fulfill all these criteria and had the presumptive diagnosis of an atrial septal defect were found at cardiac catheterization to have no demonstrable left to right shunt or other significant abnormality. The results of standard T-M mode echocardiograms were verified with B scan ultrasonograms. These cases may represent an early stage in the development of a cardiomyopathy. There is no echocardiogram pathognomonic of an atrial septal defect, and patients whose history and echocardiogram suggest this defect should have further diagnostic evaluation including technetium scan or cardiac catheterization.

Adult↗
PubMed1976

Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence of absence of asynergy.

The relation of minor and major axes of the left ventricle was determined in 100 left ventriculograms performed in the right anterior oblique projection. This relation taken over a wide range of volumes was used to derive a theoretically correct equation for determination of ventricular volume by echocardiography. The final equation was: V =[7.0/2.4 +d] (D3), where V = volume and D = the echocardiographically measured internal dimension. In 12 patients without asynergy, this equation accurately and directly calculated end-systolic and end-diastolic volumes whether the left ventricle was small or large. However, in 12 patients exhibiting left ventricular asynergy the correlation between angiographically and echocardiographically determined volumes was poor. Thus, caution is recommended in the use of time-motion echocardiography to calculate ventricular volumes in patients with coronary artery disease and possible left ventricular asynergy.

Angiocardiography↗