Shone's complex with dextrocardia and situs inversus totalis: a case report

Parachute mitral valve complex is an unusual congenital anomaly that has been described by Shone et al. It is characterized by a parachute deformity of the mitral valve associated with additional forms of left heart anomalies, such as aortic valvular stenosis and coarctation of the aorta. A 21-year-old female who was referred to our department because of progressive dyspnea on effort and at rest and minimal cyanosis is presented in this case report. On cardiac auscultation, the patient had a grade III/VI pansystolic murmur best heard at the lower left sternal border. The chest X- ray demonstrated dextrocardia and mild cardiomegaly. Echocardiographic evaluation revealed Shone's complex, including parachute mitral valve anomaly

Hipertrofik kardiyomiyopatide renkli doppler görüntüleme ile atriyal fonksiyonların değerlendirilmesi

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Objective: Deterioration in atrial functions can lead to acute hemodynamic decompensation in patients with hypertrophic cardiomyopathy (HCM). The question of whether the atrial dysfunction may be explained primarily by the hemodynamic impact of left ventricle on atria or an underlying cardiomyopathic process remains unresolved. We aimed to investigate atrial functions in patients with HCM by using atrial myocardial color doppler imaging. Material and Methods: Left atrial (LA) and right atrial (RA) functional parameters in 15 patients with HCM and 15 age matched healthy controls were compared echocardiographically. Left atrial volumes and LA ejection fraction (LA ejection volume/Vmax X 100) were calculated. Atrial myocardial systolic, early and late diastolic velocities, peak systolic strain (SI) and strain rate (SR) were all measured by color doppler myocardial imaging.Amaç: Atriyal fonksiyonlarda bozulma Hipertrofik kardiyomyopatili (HKMP) hastalarda akut hemodinamik dekompanzasyona neden olabilir. Atriyal fonksiyonlardaki bozulmanın sol ventrikülün atriyum üzerindeki hemodinamik etkisine mi yoksa altta yatan kardiyomiyopatik proçese mi bağlı olduğu sorusu halen çözülememiştir. Biz bu çalışmada, HKMP'li hastalarda atriyal miyokardiyal renkli doppler görüntüleme ile atriyal fonksiyonları araştırmayı hedefledik. Gereç ve Yöntemler: HKMP'li 15 hasta ile yaşları uyumlu 15 sağlıklı kontrol bireyinin sol atriyal (LA) ve sağ atriyal (RA) fonksiyonel parametreleri ekokardiyografik olarak karşılaştırıldı. Sol atriyal hacim ve LA ejeksiyon fraksiyonu (LA ejeksiyon hacmi/Vmaks X 100) hesaplandı. Atriyal miyokardiyal sistolik velosite, erken ve geç diyastolik velosite, pik sistolik 'strain' (SI) ve 'strain rate' (SR) ölçümleri renkli doppler miyokardiyal görüntüleme yöntemi kullanılarak yapıldı

Do Physicians Measure Patients' Blood Pressure, and Are Those Measurements Reliable? (Meeting Abstract)

27th Scientific Meeting of the International-Society-of-Hypertension -- SEP 20-23, 2018 -- Beijing, PEOPLES R CHINA[No Abstract Available]Int Soc Hyperten

Do Physicians Measure Patients' Blood Pressure, and Are Those Measurements Reliable?

To determine how and how often blood pressure (BP) measurement is performed in health institutions. The researchers observed whether or not 84 physicians performed BP measurement. Immediately after BP measurement by the physician, this was repeated by the researchers in a manner compatible with HT guidelines. The physicians' and researchers' BP measurement results were compared. Physicians measured BP in only 37% (427) of 1130 consecutive patient examinations. None of the physicians BP measurements were fully compatible with the guidelines BP measurement recommendations. Physicians who performed measurements determined the same SBP and DBP as the researchers in 34.3% of patients. Hypertension was determined in 18.9% of patients in clinics in which BP measurement was not performed by physicians. Not all physicians in our study measured BP, and the great majority of those who did failed to measure it reliably. We think that it is therefore vitally important for physicians across the world to receive regular, repeated, and effective training in the importance of BP measurement and how to perform it correctly

Koroner arter hastası olan genç ve yaşlı hastaların risk faktörleri, klinik ve anjiyografi bulguları açısından karşılaştırılması

Amaç: Bu çalışmamızdaki amacımız, ülkemizdeki 40 yaş altı ile 40 yaş ve üzerindeki koroner arter hastalarındaki konvansiyonel risk faktörleri, koroner anatomi ve erken klinik seyri incelemektir. Yöntemler: Akut koroner sendrom (AKS) veya kararlı anjina pektoris tanılarıyla kliniğimizde yatırılarak koroner anjiyografisi (KAG) yapılmış olan toplam 491 hasta geriye dönük olarak incelendi. Kırk yaş altındaki hastalar (grup 1) ile ?40 yaş hastaların (grup 2) demografik ve KAG verileri karşılaştırıldı. Bulgular: Hastaların 240’ı grup 1’de (ortalama yaş 35.7±3.4 yıl); 251’i grup 2’de (ortalama yaş 61.0±9.7 yıl) yer almaktaydı. Grup 1’de sigara kullanımı, aile öyküsü, hiperkolesterolemi, hipertrigliseridemi ve düşük yüksek yoğunluklu lipoprotein kolesterol düzeyi daha sık iken; Grup 2’de hipertansiyon ve diyabet sıktı. Kırk yaş altı hastalar sıklıkla AKS nedeniyle, ?40 yaş hastalar ise stabil angina ile hastaneye başvurmaktaydılar. Grup 2’deki hastalarda ciddi ve yaygın koroner arter hastalığı, Grup 1’deki hastalarda ise tek damar hastalığı yaygındı. Sonuç: Koroner arter hastalığı risk faktörleri ve yaygınlığı yaşa göre farklılık göstermektedir. Kırk yaş altı koroner arter hastalarında engellenebilir bir risk faktörü olarak sigara kullanımı ve dislipideminin görece fazlalığı toplum sağlığımız için ciddi bir tehdit oluşturmaktadır. Sigara kullanımı konusunda yeni tedbirler alınması ve sağlıklı yaşam biçiminin genç yaşlardan itibaren özendirilmesi önem taşımaktadır.Objective: In this study we aimed to examine the angiographic findings, traditional risk factors and natural history of Turkish patients <40 and &amp;#8805;40 years old with coronary heart disease (CHD). Methods: The records of 491 patients with stable angina pectoris or acute coronary syndrome (ACS), who had undergone coronary angiography (CAG) were reviewed. The patients <40 years (group 1) and &amp;#8805;40 years (group 2) were compared. Results: The study population was classified as group 1 with 240 patients (mean age 35.7±3.4 years) and group 2 with 251 patients (mean age 61.0±9.7 years). Smoking, family history, hypercholesterolemia, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol were more prevalent in group 1 while diabetes mellitus, hypertension was higher in group 2. The common presentation among <40 years patients was ACS whereas stable angina was the most common presentation in patients &amp;#8805;40 years old. Patients in group 1 showed a preponderance of single-vessel disease whereas patients of group 2 showed dominance of multivessel disease. Early clinical course of patients with ACS in group 1 was better than in group 2. Conclusion: Our study shows a significantly different clinical, angiographic and biochemical profile in <40 years patients with CHD compared with &amp;#8805;40 years patients. Dominance of smoking and dyslipidemias that are the preventable risk factors in premature CHD patients is an important threat for our community health. Healthy life styles should be encouraged beginning from young ages and new precautions about smoking must be taken