Abstract
In the last few decades there has been increasing recognition of left ventricular dysfunction in patients with rheumatic mitral valvular disease. This so-called “myocardial factor” 1 Harvey RM Ferrer MI Samet P. et al. Mechanical and myocardial factors in rheumatic heart disease with mitral stenosis.. Circulation. 1955; 11: 531-551 Crossref PubMed Scopus (62) Google Scholar , 2 Fleming HA Wood P. The myocardial factor in mitral valve disease.. Br Heart J. 1959; 21: 117-122 Crossref PubMed Scopus (39) Google Scholar has been ascribed to rheumatic myocarditis, vasculitis, coronary arterial rheumatic myocarditis, vasculitis, coronary arterial emboli 3 Hildner FJ Javier RP Cohen LS et al. Myocardial dysfunction associated with valvular heart disease.. Am J Cardiol. 1972; 30: 319-326 Abstract Full Text PDF PubMed Scopus (76) Google Scholar or the secondary effects of concomitant right ventricular enlargement. Cineventriculographic study has identified varying degrees of impaired anterolateral wall contractility in such subjects. 4 Curry GC Elliott LP Ramsey HW Quantitative left ventricular angiocardiographic findings in mitral stenosis.. Am J Cardiol. 1972; 29: 621-627 Abstract Full Text PDF PubMed Scopus (60) Google Scholar We describe here the apexcardiogram of a patient with mitral valvular disease, a markedly abnormal left ventricular apical impulse and abnormal left ventricular wall motion.
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