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Vedat Davutoglu

Publications and source records attributed to Vedat Davutoglu.

44 records · Page 3Linked to original sources
PubMed2002

Constrictive pericarditis localized to left ventricle presented with left pleural effusion: a case report.

An 18-year old woman presented with progressive dyspnea and cough. Physical examination revealed decreased breath sounds at the left hemithorax and distant heart sounds with no murmurs or rub. Electrocardiogram revealed low voltage. Chest X-ray showed unilateral left-sided pleural effusion with no cardiomegaly. Transthoracic echocardiogram showed thickened pericardium localized throughout the left ventricle impairing the diastolic filling. Doppler waveforms were suggestive of localized constrictive pericarditis. A computerized tomographic scan of the chest confirmed the presence of unilateral pleural effusion with thickened pericardium surrounding the left ventricle. The patient's symptoms and signs were related to localized constrictive pericarditis and improved following surgery.

Adolescent↗
PubMed2002

Silent brain infarction in patients with rheumatic mitral stenosis.

Silent brain infarction (SBI) is defined as asymptomatic infarction areas detected in computerized tomography (CT) scans in patients without a history of stroke. The incidence of SBI is increased in CT or magnetic resonance imaging in patients with carotid stenosis and with atrial fibrillation (AF), but its relation with rheumatic mitral stenosis (MS), another major source of emboli, is uncertain. The aim of this study was to investigate the incidence of SBI in patients with MS. Fifty-three patients with MS (44 females and 9 males; range 25-52 years; mean age 38 +/- 7 years) diagnosed by transthoracic echocardiography (TTE) were enrolled in the study. Mitral valve calcification, left atrium (LA) dimension, and the presence of associating mitral regurgitation on TTE were recorded. Electrocardiographic evaluation was done for rhythm analysis and neurologic examination was performed prior to cerebral CT. Carotid artery Doppler examination was carried out in patients with SBI to exclude carotid artery lesions. Patients with a history of hypertension, diabetes mellitus, anticoagulant drug usage, presence of thrombus in LA, left ventricular segmental or systolic dysfunction, or other valve diseases were excluded from the study. The incidence of SBI was found to be 24.5% in patients with MS (47% cortical, 53% lacunar). SBI was observed to be significantly high in patients with LA dimension > 4 cm or in patients with AF (p < 0.05). The SBI incidence was markedly higher if AF was found with enlarged LA when compared with patients having sinus rhythm and small LA (p < 0.01). When moderate to severe mitral regurgitation was associated with MS, the SBI incidence was found to be lower (p < 0.05). Although SBI was higher in patients with MVA < 1.5 cm2, it was not statistically significant (p > 0.05). No significant correlation was found between calcific and noncalcific valves for SBI (p > 0.05). Our data suggest that SBI may be expected in about 1/4 of patients with MS. The presence of LA enlargement and AF increase the incidence of SBI in patients with MS, whereas the presence of moderate to severe mitral regurgitation decreases the incidence of SBI.

Adult↗
PubMed2002

Does exercise-induced severe ischaemia result in elevation of plasma troponin-T level in patients with chronic coronary artery disease?

OBJECTIVE: It has been reported that the loss of cell membrane integrity during severe reversible ischaemia results in elevation of plasma troponin T (TnT) in unstable angina. We investigated whether TnT is released into circulation during severe ischaemia (e.g. on treadmill exercise testing) in patients with chronic coronary artery disease (CAD). METHODS AND RESULTS: The study comprised 54 patients who had angiographically documented CAD (22 of them had a prior history of myocardial infarction) and 18 normal subjects. All cases underwent exercise thallium (Tl)-201 SPECT myocardial perfusion imaging. Blood samples for TnT analysis were obtained for each patient at pre-exercise, immediately after and 12 hours after exercise. SPECT images were divided into 20 segments. Patients with redistribution defects > or = 5 were considered to have severe ischaemia. Sixteen patients had severe ischaemia on SPECT images. The mean TnT levels of the patients with severe ischaemia at pre-exercise, immediately after and 12 hours after exercise were 0.009 +/- 0.008, 0.012 +/- 0.009 and 0.010 +/- 0.010 ng/ml, respectively. In normal subjects the mean TnT levels were 0.012 +/- 0.009, 0.010 +/- 0.009, 0.010 +/- 0.010 ng/ml, respectively. There was no significant difference neither between the two groups nor within each group with respect to pre-exercise and post-exercise TnT results. All TnT levels were within normal limits (< 0.1 ng/dl). Additionally, when the patients were grouped according to other SPECT variables (patients with reversible defects vs. fixed defects; patients with increased lung uptake of Tl-201 vs. without lung uptake; patients with transient left ventricle dilatation vs. those without) and angiographic findings (patients with multivessel disease vs. normal subjects), there were no significant differences with respect to pre-exercise and post-exercise TnT results. CONCLUSION: Severe ischaemia does not result in the elevation of the plasma TnT level in patients with chronic CAD.

Adult↗
PubMedDate not supplied

Unruptured giant left ventricular pseudoaneurysm complicating silent myocardial infarction in a diabetic young adult: left ventricular giant pseudoaneurysm after silent myocardial infarction.

We report a very rare case of a 36-year-old diabetic man who had a silent myocardial infarction, a ruptured myocardial wall, and an unruptured left ventricular pseudoaneurysm. The patient admitted with a 3-month history of dyspnea on exertion, without evidence of acute coronary syndrome. Coronary angiography showed severe stenosis of the right coronary artery. Echocardiography, multiple gated acquisition radionuclide scan (MUGA) and left ventricular angiography revealed giant left ventricular posterolateral pseudoaneurysm next to the left ventricle. Patient underwent to surgery with excellent results. We present this case because rarity and high clinical index of suspicion is needed to avoid missing the diagnosis in such an unusual sequence of silent myocardial infarction in diabetic patient. The clinical picture of dyspnea in a diabetic patient in presence of a diagnostic echocardiographic finding warrants coronary angiography to document the ischemic etiology of the pseudoaneurysm in view of prompt surgical correction.

Adult↗
PubMedDate not supplied

A case of massive dystrophic cardiac calcinosis with increased bone resorption markers: a novel pathophysiologic link?

We report a 72-year-old man who presented to our emergency room with congestive heart failure that was resistant to initial medical therapy. He had suffered from anterior myocardial infarction 20 years prior. Echocardiography and computed tomography revealed marked cardiac calcification including myocardium, chordal structures, mitral annulus, and aortic valve. Neither chronic renal insufficiency nor hypercalcemia were present in our patient. Bone resorption markers were increased and bone mineral density was consistent with severe osteoporosis. We suggested a novel mechanism, that increased bone resorption may lead to accumulation of calcium into avascular tissues in the heart (ie, chordal structures, mitral annulus, aortic valve, and fibronecrotic myocardium) especially in the setting of high left ventricular end-diastolic pressure. Dystrophic cardiac calcinosis, an age-related cardiomyopathy, is associated with elevated bone resorption markers and it may cause alterations in cellular calcium hemostasis with initiation of deleterious events leading to aggravate dilated and restrictive cardiomyopathy and may result in intractable congestive heart failure. The implication of this case report needs to be reemphasized.

Aged↗
PubMedDate not supplied

Surgical treatment of postinfarction left ventricular pseudoaneurysm.

In this report, we present two cases who had left ventricular pseudoaneurysm, resection, and repair was done successfully. The repair was performed with the aid of cardiopulmonary bypass. The neck of the pseudoaneurysm was closed with autologous fresh pericardial patch. The surgical treatment of ventricular pseudoaneurysm depends upon their origin, size, and local extension.

Aged↗