Anterolateral Wall Of Left Ventricle Research Articles

Carditis as unrecognized extra-pulmonary complication of Mycoplasma pneumoniae infection in adults: a case report

A 44 years old man admitted to the hospital with fever and sudden onset of severe oppressive chest pain localized in the left breast area, radiating to the left arm. Examination revealed blood pressure 120/80 mm Hg, respiratory rate 18/min, heart pulse rate 100 beats/min, oxygen saturation (SpO2) of 96—98 % on room air, flatness to percussion and presence of inspiratory crackles in the left basal area. EKG showed sinus tachycardia and non-specific alteration of repolarization in the anterolateral area of left ventricle. Troponin I and CK-MB, CRP and erythrosedimentation rate were considerably elevated. Chest radiograph performed at the admission revealed left basal consolidation with an effusion, suggesting pneumonia. On the basis of this data atypical pneumonia with cardiac complication was suspected and serum titers for respiratory viruses and atypical microorganism was performed. Antibodies (IgM) to M. pneumoniae were positive with high titer. Cardiac MRI was performed and showed tissue edema areas and multiple «late enhancement» myocardial areas on the anterolateral wall of left ventricle. Pneumonia and carditis due to Mycoplasma pneumoniae were successfully treated with clarithromycin 500 mg twice daily and ceftriaxone 2 g one daily for fifteen days.

Comprehensive Evaluation of Cardiac Hydatid Using 256 Slice Dual Source CT: One Stop Shop

Hydatid disease results from infection with larval stage of Echinococcus granulosus tapeworm. Dogs and other canines are the definitive hosts; Human beings are common accidental intermediate hosts. Liver is the most common organ to be involved in this condition. Cardiac hydatid, seen in only 0.5 to 2% cases, is a rare entity because of myocardial contractility. Larvae reach the myocardium through coronary circulation. Among various locations of cardiac hydatid, due to its rich coronary arterial supply Left ventricle (LV) myocardium is the most common site of involvement followed by interventricular septum and right ventricle. Rare locations include pericardium, right atrium and left atrium. A 50-year-old woman presented with dyspnoea for 11 months, chest X-ray showed a well defined, homogenous left paracardiac mass, which is not separable from left heart border. Transthoracic echocardiography revealed a complex multicystic mass lesion abutting antero-lateral wall of left ventricle. Contrast enhanced computed tomography showed a well-circumscribed multicystic mass lesion with honeycomb appearance arising from myocardium of anterolateral wall of left ventricle. Indirect haemagglutination test for hydatid disease was positive. At surgery the cyst was seen to arise from LV myocardium. It was incised and grape like contents were evacuated. The cavity was irrigated with scolicidal solution. Thereafter, the cyst was marsupialised. Histopathological examination revealed grape like cyst contents consistent with the diagnosis of hydatid cyst.

左室肥大心電図(収縮期負荷)と左軸偏位(Frank法ベクトル心電図による検討)

It is usually considered that isolated left ventricular hypertrophy is not responsible for marked left axis deviation, and it is associated with left anterior fascicular block. From this point of view, morphological features were studied on the vectorcardiograms recorded with the Frank's system in 63 cases. They had diseases producing systolic overload on left ventricle (mainly essential hypertension) revealed out left ventricular hypertrophy in Ecg findings. They were divided into three groups based on electrical QRS axis as follows: (i) NAD group consisted with+90°-0°. (ii) LAD' group consisted with 0°--30°. (iii) LAD group consisted with -30°--90°. The patterns of QRS Loop classified into 5 types in horizontal plane (NI, II, LI-III) and 4 types in frontal plane (A-D). In horizontal plane, 75% of NAD group showed type NI, or NII, and type LI, or LII occupied in 75% of LAD group. In frontal plane, a half of LAD belonged to type D and type A was less than 10% in LAD, compared that type A was observed in 85% of NAD. Left ventriular hypertrophy with marked left axis deviation was classified into three types on the base of QRS loop as follows: the terminal portion of QRS loop directed superiorly to the left (type B) and superiorly to the right (type C), and the majority of QRS loop located to leftward and superiorly (type D). It was considered that the electrical force caused by hypertrophied left ventricle directed more posteriorly and to the left in type B, and type D was the pattern added to type B with the delayed excitation in antero-lateral wall of left ventricle caused by left anterior fascicular block. On the other hand, it was considered that the majority of type C, showing type NII, was the resultant of the delayed excitation in postern-basal portion of ventricles and was not closely related with left ventricular hypertrophy or left anterior fascicular block.