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Biomedical subjects

T O Cheng

Publications and source records attributed to T O Cheng.

At least 685 records · Page 38Linked to original sources
PubMed1978

Continuous precordial murmur due to congenital fistula between the femoral artery and the superior vena cava.

An unusual case of arteriovenous communication between the left inferior epigastric artery, a branch of the femoral artery, and the superior vena cava is presented. The communication caused a continuous murmur at the lower parasternal area and was responsible for a significant left-to-right shunt. Surgical treatment, which consisted of ligation of the aberrant artery at its origin, was followed by disappearance of the precordial murmur.

Adult↗
PubMed1977

Systolic mitral flutter, an echocardiographic clue to the diagnosis of ruptured chordae tendineae.

A new finding of fine systolic fluttering of the mitral leaflet is described in two patients with ruptured chordae tendinease and severe mitral regurgitation. The flutter is caused by the action of high-velocity blood flow upon the leaflet margin that has lost its support. The jet stream of blood evokes a high-frequency vibratory motion of the tensed leaflet as opposed to the previously described, lower frequency, less specific, diastolic flutter. This finding was not seen in the echocardiograms of 75 patients with other forms of mitral regurgitation. Systolic flutter appears to be specific for ruptured chordae tendineae.

Adult↗
PubMed1976

Multifascicular block in cardiomyopathy. Incidence, localization by His bundle study and prognosis.

Of 70 patients with cardiomyopathy, nine (13%) had bifascicular block: right bundle branch block with left anterior hemiblock in four, right bundle branch block with left posterior hemiblock in two, and left bundle branch block with left anterior hemiblock in three. Isolated left bundle branch block was present in four, isolated left anterior hemiblock in 13, and isolated left posterior hemiblock in one. No isolated right bundle branch block was found. Five of the patients with bifascicular block were evaluated by His bundle electrocardiography and atrial pacing. Block in the His-Purkinje system (prolonged HV interval) was present in four and atrioventricular conduction (AH interval) was normal in all five. Despite a common prolongation in intraventricular conduction, short term prognosis seems to be favorable since: (1) none had spontaneous progression to more advanced block or experienced Stokes-Adams attacks for an average follow-up period of at least 42 months, and (2) with atrial pacing, one-to-one atrioventricular conduction persisted to rates up to 150/min in all patients with no further prolongation of HV interval.

Adult↗
PubMed1976

Striking electrocardiographic changes associated with pheochromocytoma. Masquerading as ischemic heart disease.

A patient with pheochromocytoma presented striking electrocardiographic changes mimicking ischemic heart disease at one time and acute pulmonary embolism at other times. Diffuse left ventricular hypokinesia was demonstrated in the presence of normal coronary arteries. Following removal of the pheochromocytoma, the electrocardiographic abnormalities disappeared.

Blood Pressure↗
PubMed1976

Paradoxical embolism. A diagnostic challenge and its detection during life.

Two cases of paradoxical embolism, one with recurrent cerebral embolism and one with brachial and coronary embolism and both associated with pulmonary embolism, were diagnosed during life. Although there was neither pulmonary hypertension nor intracardiac shunt present at the time of cardiac catheterization in both cases, the presence of a patent foramen ovale with an interatrial right-to-left shunt was demonstrated by a simple ascorbate dilution technique following a Valsalva maneuver. Each patient was treated by surgical interruption of the inferior vena cava and did well. Paradoxical embolism should be included in the differential diagnosis of arterial embolism for which there is no obvious source, especially when there is also evidence of venous thrombosis or pulmonary embolism.

Cardiac Catheterization↗
PubMed1975

Complete heart block with normal QRS duration occurring distal to the his bundle in acute inferior myocardial infarction.

A patient with acute inferior myocardial infarction developed on the second day complete heart block with normal QRS duration, and the block was found to be distal to the His bundle. To our knowledge, this is the first such documented case in the English literature. Failure of the preceding Wenckebach periods and of complete heart block to respond to intravenous atropine may be a clinical clue to the nature of this type of heart block. The implications and possible explanations are discussed in the light of recent knowledge concerning the nature of heart block in inferior wall myocardial infarction.

Acute Disease↗