Schwannomas of head and neck and review of literature.

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion.

Real time three-dimensional transesophageal echocardiography in partial posteromedial papillary muscle rupture.

A 60-year-old hypertensive male with non-ST segment elevation myocardial infarction had a hyperdynamic LV with mild posterior leaflet mitral valve prolapse without significant regurgitation on transthoracic echocardiogram. Two-dimensional (2D) TEE showed severe mitral regurgitation with prolapse of P2 and P3 scallops. Posteromedial papillary muscle rupture was suspected.

Snake heart: a case of atavism in a human being.

Atavism is the rare reappearance, in a modern organism, of a trait from a distant evolutionary ancestor. We describe an apparent case of atavism involving a 59-year-old man with chest pain whose coronary circulation and myocardial architecture resembled those of the reptilian heart. The chest pain was attributed to a coronary steal phenomenon.

Migraine and vasodepressor syncope in a large family.

We evaluated a 47-year-old woman for recurrent migraine and syncope. The patient had 7 children (not examined by the authors), all of whom also experienced migraine and syncope. The patient's father, now deceased, had reportedly experienced migraine and episodes of feeling faint.

Timely follow-up of abnormal diagnostic imaging test results in an outpatient setting: are electronic medical records achieving their potential?

Background: Given the fragmentation of outpatient care, timely follow-up of abnormal diagnostic imaging results remains a challenge. We hypothesized that an electronic medical record (EMR) that facilitates the transmission and availability of critical imaging results through either automated notification (alerting) or direct access to the primary report would eliminate this problem.

Methods: We studied critical imaging alert notifications in the outpatient setting of a tertiary care Department of Veterans Affairs facility from November 2007 to June 2008.

Use of fractional flow reserve and intravascular ultrasonography to evaluate ambiguous left main coronary artery stenosis.

Because angiography provides only a 2-dimensional image, it is an imperfect tool for accurately evaluating left main coronary artery stenosis. Additional methods, such as fractional flow reserve evaluation and intravascular ultrasonography, are more frequently being used to gauge the physiologic significance of angiographically ambiguous left main coronary artery stenosis. Previous studies have shown that a fractional flow reserve cutoff value of less than 0.

Devices for heart failure: the future is now.

Despite impressive strides in pharmacologic therapy for heart failure (HF), cumulative evidence from epidemiologic studies suggests that there has been no improvement in the prognosis for this condition over the past 40 years. Several aspects of the pathophysiology of HF are not influenced by drug therapy. Hospitalizations for acute decompensated HF have continued to increase in recent years despite the use of complex and costly drug regimens.

Percutaneous ventricular assist device support in a patient with a postinfarction ventricular septal defect.

Complications of acute myocardial infarction have decreased in number and severity due to the application of early thrombolytic coronary revascularization techniques. Nonetheless, the mortality rate associated with these complications remains high. Ventricular septal rupture is one of the complications that can occur after myocardial infarction.

Contrast echocardiography for right-sided heart conditions: case reports and literature review.

Contrast echocardiography is recognized to be a safe, effective technique for evaluating the endocardial border and left ventricular function in patients who have suboptimal non-contrast echocardiograms. However, its use in diagnosing right-heart conditions is less well established. Herein, we report our experience with the use of contrast echocardiography for diagnosing 3 distinct right-sided heart conditions (hypokinesis of the right ventricular free wall, severe tricuspid regurgitation, and cardiac tamponade) in patients who had suboptimal echocardiograms.

Communication outcomes of critical imaging results in a computerized notification system.

Objective: Communication of abnormal test results in the outpatient setting is prone to error. Using information technology can improve communication and improve patient safety. We standardized processes and procedures in a computerized test result notification system and examined their effectiveness to reduce errors in communication of abnormal imaging results.