Efficacy of high dose intravenous heparin for treatment of left ventricular thrombi with high embolic risk.

Objectives: This study was performed to assess the efficacy of high dose intravenous heparin to treat mobile or protruding left ventricular thrombi as detected by serial echocardiography.

Background: The presence of mobile and protruding left ventricular thrombi greatly increases the risk of arterial embolization, yet optimal therapy, be it thrombolysis, anticoagulation or surgical removal, has not been defined.

Methods: Full dose heparin, 31,291 +/- 7,980 (mean +/- SD) IU/day, to prolong partial thromboplastin time to at least twice normal, was administered intravenously to 23 consecutive patients with 25 mobile and protruding thrombi.

Noninvasive estimation of regurgitant flow rate and volume in patients with mitral regurgitation by Doppler color mapping of accelerating flow field.

Objectives: This study was designed to examine the accuracy of proximal accelerating flow calculations in estimating regurgitant flow rate or volume in patients with different types of mitral valve disease.

Background: Flow acceleration proximal to a regurgitant orifice, observed with Doppler color flow mapping, is constituted by isovelocity surfaces centered at the orifice. By conservation of mass, the flow rate through each isovelocity surface equals the flow rate through the regurgitant orifice.

[Floating intracardiac metastasis].

Two years after the removal of an embryonic testicular tumour from a now 26-year-old man, his general health deteriorated and a holosystolic murmur was heard over the tricuspid valve area. A chest X-ray film demonstrated lung metastases. Biochemical tests were within normal limits, but the human chorionic gonadotrophin level was elevated to 81,030 mU/ml.

[Primary hypothyroidism in normal thyroid gland morphology].

A 25 year old patient developed hypothyroidism with antibodies against thyroglobulin, thyroid microsomes and thyrotropin receptors. Thyroid 99m-technetium-uptake was 0%. Ultrasound investigation revealed a normal sized, homogenous thyroid gland.

[Pneumopericardium with combined emphysema of the skin and mediastinum following tooth extraction].

Emphysemas of the skin in the region of the cheek and face after surgical tooth extraction are relatively rare complications that can eventually lead to formation of an emphysema of the mediastinum and very rarely also to a pneumopericardium. The reason for this is often an instrumentally conditioned pressure increase in the oropharynx if this pressure increase leads to the entry of air into the wound region. There are also other mechanisms resulting in the formation of spontaneous mediastinal emphysema that can lead to a secondary emphysema.