A vanishing right ventricular mass

Vanishing intracardiac masses can emerge as a diagnostic and therapeutic dilemma. The most common causes of intracardiac masses are thrombi, vegetations and primary or metastatic tumors. A 73-year-old male patient was admitted to internal medicine clinic with the diagnosis of acute postrenal failure superimposed on chronic renal failure. He also had fever and urinary tract infection. Eosinophil count was 1975/mm3 (22.7%). Transthoracic echocardiography (TTE) revealed a 12x10 mm mobile mass attached to right ventricular (RV) lateral wall. The patient was on bicarbonate, sulbactam+cefoperazone 2x1 g, enoxaparine 1x4000 IU and silodosin 1x8 mg, when the patient discharged. One month after discharge, the patient came back for control examination. Surprisingly, control TTE revealed complete disappearance of the RV mass. Eosinophil count was 500/mm3 (4.9%). Intracardiac masses may emerge as a feature of hypereosinophilic state and may resolve in due course by recovery of hypereosinophilia and adjunct anticoagulation. © 2016 OMU

Aneurysm of the basal interventricular septum secondary to turbulent flow jet from a mitral prosthetic valve

WOS: 000353739600015PubMed: 25701978Aneurysms of the muscular interventricular septum, most of which are congenital, have been rarely reported.1,2 Usually, the affected site is the mid portion of the trabecular interventricular septum, whereas aneurysms of the basal interventricular septum are rare. A 24-year-old man who underwent mitral valve replacement with a tilting disc prosthesis in 2003 applied for medical examination for a job application and transthoracic echocardiography (TTE) was ordered by his physician

The role of neutrophil to lymphocyte ratio as a predictor of diastolic dysfunction in hypertensive patients

Gul, Murat/0000-0001-9950-699XWOS: 000351491800018PubMed: 25720715OBJECTIVE: Neutrophil to lymphocyte ratio (NLR) is a novel parameter for cardiovascular research area. The higher values of NLR have been found to be associated with worse clinical outcomes in atherosclerotic heart disease, heart failure, heart valve disease and other various cardiovascular disorders. Although the relationship between NLR and almost all cardiovascular disorders have been investigated, the association between NLR and diastolic dysfunction remains unclear. We herein evaluated the association between NLR and diastolic dysfunction. PATIENTS AND METHODS: The study population consisted of 41 hypertensive patients with any grade of diastolic dysfunction and 41 hypertensive patients without diastolic dysfunction determined by echocardiographic evaluation constituted the control group. RESULTS: Mean NLR value was found to be 2.07 +/- 0.82 in the diastolic dysfunction group while the control group had a mean value of 1.69 +/- 0.60 (p = 0.020). The patients with diastolic dysfunction had significantly higher values of NLR. When grades of diastolic dysfunction were evaluated, NLR was 1.80 +/- 0.82, 2.32 +/- 0.73 and 2.75 +/- 0.45 in patients with grade 1, grade 2 and grade 3 diastolic dysfunction, respectively. The patients with higher grade of diastolic dysfunction had higher values of NLR (p = 0.001). None of the other hematologic parameters differed significantly in patients with diastolic dysfunction when compared to controls. CONCLUSIONS: Patients with diastolic dysfunction had higher values of NLR compared to subjects without diastolic dysfunction. Furthermore higher grades of diastolic dysfunction were associated with higher levels of NLR. Further studies are needed to search the possible use of NLR as a marker for prognostic stratification in diastolic dysfunction which is associated with worse cardiovascular outcomes

Zwiększenie średniej objętości płytek krwi w zwężeniu zastawki mitralnej o podłożu reumatycznym: ocena determinantów klinicznych i echokardiograficznych

Background and aim: The aim of this study was to investigate mean platelet volume (MPV) in patients with rheumatic mitral stenosis (RMS) and to define the determinants of a possible platelet activation reflected as platelet volume enlargement. Methods: Peripheral venous plasma value of MPV was measured in 84 consecutive patients (16 men, 68 women; mean age ± SD = 44 ± 13 years) with RMS who had no left atrial thrombus by transoesophageal echocardiography. The control group consisted of 32 healthy subjects (nine men, 23 women; mean age ± SD = 38 ± 7 years). Results: The patients had significantly higher MPV values (mean ± SD = 10.07 ± 0.58 fL) compared to the healthy subjects (mean ± SD = 8.15 ± 0.60 fL, p < 0.001). Among many clinical and echocardiographic variables, left atrial spontaneous echo contrast-positivity (beta = 0.426, p < 0.001) and severe mitral regurgitation (beta = 0.577, p < 0.001) appeared as significant predictors of platelet enlargement in RMS in multiple linear regression analysis. Conclusions: Patients with RMS have increased platelet activity reflected as elevated MPV; and the coexistence of severe mitral regurgitation and presence of left atrial spontaneous echo contrast are determinants of this increment.Wstęp i cel: Celem badania było określenie średniej objętości płytek krwi (MPV) u chorych ze zwężeniem zastawki mitralnej spowodowanym chorobą reumatyczną (RMS) i zdefiniowanie determinantów potencjalnej aktywacji płytek krwi przejawiającej się zwiększeniem ich objętości. Metody: Średnią objętość płytek w osoczu krwi obwodowej zmierzono u 84 kolejnych pacjentów (16 mężczyzn, 68 kobiet; średnia wieku ± SD = 44 ± 13 lat) z RMS, u których nie stwierdzono skrzeplin w lewym przedsionku w echokardiografii przezprzełykowej. Grupa kontrolna składała się z 32 zdrowych osób (9 mężczyzn, 23 kobiety; średnia wieku ± SD = 38 ± 7 lat). Wyniki: U chorych z RMS stwierdzono istotnie większe wartości MPV (średnia ± SD = 10,07 ± 0,58 fl) niż u osób zdrowych (średnia ± SD = 8,15 ± 0,60 fl, p < 0,001). W analizie regresji liniowej wykazano, że spośród wielu zmiennych klinicznych i echokardiograficznych istotnymi czynnikami predykcyjnymi zwiększenia objętości płytek krwi w RMS jest samoistne kontrastowanie się krwi w lewym przedsionku (beta = 0,426; p < 0,001) i ciężka niedomykalność zastawki mitralnej (beta = 0,577; p < 0,001). Wnioski: U chorych z RMS aktywność płytek krwi jest nasilona, co przejawia się w zwiększonej MPV, a współistnienie ciężkiej niedomykalności zastawki mitralnej i samoistnego kontrastowania się krwi w lewym przedsionku stanowi czynnik determinujący tę zwiększoną aktywność płytek