A case of lipomatous hypertrophy of right ventricle

Lipomatous hypertrophy is a condition that is being increasingly diagnosed with the advent of newer modalities. A middle aged lady was referred to us with recent onset dyspnea and palpitations. Echocardiography revealed diffuse thickening of the right ventricular free wall and outflow tract. Endomyocardial biopsy revealed this as a lipomatous hypertrophy involving the right ventricle. This is the first reported case of lipomatous hypertrophy involving the right ventricle.     

Arrhythmogenic dysplasia of the right ventricle. Description of a case

A 43 year old man was admitted to our Clinic because of recurrent episodes of palpitation. The electrocardiogram showed incomplete right bundle branch block, frequent ventricular extrasystoles with left bundle branch block morphology and negative T waves in the precordial leads. Two dimensional echocardiography showed marked right ventricular dilatation and right ventricular radionuclide angiography located the enlargment in the infundibulum. Arrhythmogenic right ventricular dysplasia was then suspected. Cardiac angiography excluded the other most common causes of right ventricular dilatation and confirmed the diagnosis. Arrhythmogenic right ventricular dysplasia should thus be regarded as a possible cause of ventricular arrhythmias of unknown etiology.     

Ectopic thyroid mass in the right ventricle: A case report

Ectopic thyroid is a rare congenital embryonic anomaly. Ectopic thyroid tissue can be located anywhere during its descent, but it is found primarily at the base of the tongue and in the mediastinum. It is very rarely found in the heart. Here, we report a rare case of cardiac ectopic thyroid tissue in a 53‐year‐old woman who presented with chest pain. Echocardiography revealed an intracardiac mass that was removed successfully. Histopathology confirmed that the mass was thyroid tissue without malignancy.     

Echocardiography of the communication between the left ventricle and the right atrium. A surgical case

The echocardiographical appearances in left ventricular--right atrial communication are described in a patient who later underwent surgery. Cross-sectional echocardiography was most valuable. It provided an immediate diagnosis and also localised the site of the malformation which had been suggested indirectly by the appearances on M-mode scanning. The success of reparatory surgery was confirmed by the same method.     

Traumatic rupture of the right ventricle an unusual case

A case of complete rupture of the right ventricle, resulting in hemopericardium, cardiac tamponade, and immediate death, is reported. The rupture was caused by the application of a sudden compressive force to the chest.     

Malignant non-Hodgkin's lymphoma in the superior vena cava and the right ventricle. A case report

A 39-year old patient presented with small, sudden hemoptyses and a diagnosis of pulmonary tuberculosis was made on radiographic pleural and parenchymatous lesions but without bacteriological confirmation. Two years later, the patient was admitted to hospital following severe hemoptysis. Echocardiography revealed the presence of a tumour in the right ventricular outflow tract. At surgery, nodules were also resected from the superior vena cava. Histological examination of the surgical specimens suggested that the tumour was an angiosarcoma. Six months later, the patient returned complaining of a painful swelling in the left iliac fossa. Immuno-histochemical analysis of the cardiac and abdominal tumours finally concluded that it was in fact a malignant non-Hodgkinian lymphoma.     

Secondary leiomyosarcoma of the right ventricle. A surgical report.

A 48-year-old woman developed symptoms related to a tumour attached to the outflow tract of the right ventricle. Eleven years earlier she had undergone hysterectomy for leiomyosarcoma, and 4 years later a retroperitoneal mass was removed. One year later a further retroperitoneal mass was removed, and after a further 4 years a cutaneous tumour was removed from her back. Histologically these three tumours were identical with the leiomyosarcoma removed with the uterus at the primary operation. A confident preoperative diagnosis of recurrent leiomyosarcoma within the pericardium was made, and it was possible to remove this tumour using cardiopulmonary bypass with relief of symptoms. The patient remains well 15 months after surgery.     

Echocardiographic volumetry of the right ventricle.

AIMS: The aim of our study was to define the optimal geometric model for two-dimensional volumetry of the right ventricle and its clinical validation. METHODS AND RESULTS: It has been shown in previous reports that an ellipsoidal shell model best reflects the complex right ventricular geometry. We investigated 82 patients without tricuspid regurgitation and intracardiac shunt. Measurements of right ventricular stroke volume were made in modified apical four chamber and parasternal short axis views both in end-diastole and end-systole. The following controls were used:stroke volume of right ventricle estimated by thermodilution in 22 patients, stroke volume of left ventricle calculated with Teichholz formula in 77 patients, stroke volume of left ventricle estimated by Doppler volumetry in 41 patients. The correlations between right ventricular stroke volume by echocardiography and thermodilution, left ventricular volumetry by Teichholz and Doppler were r=0.87, p<0.001; r=0.91, p<0.001; and r=0.83, p<0.001, respectively. CONCLUSION: The ellipsoidal shell model of the right ventricle is a good model for right ventricular volumetry.     

Solitary hypoplasia of the right ventricle: a case report

Hypoplasia of the right ventricle occurring as an isolated abnormality is an uncommon cause of cyanotic congenital heart disease. Its presentation in the newborn may mimic the ductus dependent and less stable right ventricular hypoplasias such as tricuspid atresia and pulmonary atresia. However, the natural history of this abnormality contrasts with those ductus dependent lesions by the rather benign course it presents. A patient with only marked reduction in right ventricular size and commensurate reduction in size of the tricuspid and pulmonary valves is described. Although cyanotic this child has shown none of the critical problems frequently encountered with the more severe forms of the right ventricular hypoplasias.     

A case of right ventricular dilated cardiomyopathy, which involved left ventricle

A case of right ventricular dilated cardiomyopathy which also involved the left ventricle was reported. On health screening, a 16-year old woman was pointed out to have multifocal PVC and cardiomegaly. Subsequently, she was admitted to our hospital because of general fatigue. CTR was enlarged to 54.9% on chest X-ray. ECG showed LBBB-type PVC, right axis deviation, low voltage and T wave changes. On UCG, RVdD was dilated to 40 mm and LVdD was 37 mm. There was no finding of abnormality of the tricuspid valve. On cardiac catheterization, there was no shunt disease. Intracardiac pressure was normal. The end-diastolic volume index (ml/m2) of RV and LV was 196.7 and 67.4, respectively. And ejection fraction (%) was 20 and 40. Ventriculography revealed diffuse dilatation of the right ventricle. And lowered contractility existed not only in the right ventricle but also in the anterior and apical segment of the left ventricle. T(1)201 myocardial perfusion imaging showed irregular perfusion defect of the left ventricle. Endomyocardial biopsy revealed marked hypertrophy, partial atrophy, disarrangement of myocyte and interstitial fibrosis of the right ventricle. This case was considered to be right ventricular dilated cardiomyopathy. It seemed to be an intermediate form of dilated cardiomyopathy since it also involved the left ventricle. It was an interesting case to illustrate the spectrum of expression of cardiomyopathy.     

A trapped thrombus in the right ventricle

We report the case of 62 year-old asymptomatic woman with a bileaflet mechanical prosthesis implanted 1 year ago. Routine transthoracic echocardiography (TTE) showed that one leaflet was fixed in semi-closed position, which was confirmed by transesophageal echocardiography (TEE) and cinefluoroscopy. The paradoxical absence of symptoms despite a complete restriction of one leaflet may be due to the fact that this patient had a very small body surface area and received a prosthesis with an excellent hemodynamic performance. The presence of a large compliant left atrial chamber may have also contributed to limit the effects of valve dysfunction on the pulmonary circulation.