Abnormal Color Flow Signal Traversing the Myocardial Wall: Not Everything is What it Appears to Be.

A case of a patient presenting with an acute myocardial infarction is presented. A transthoracic echocardiographic examination revealed an abnormal color flow signal that traversed the myocardial wall from a large inferior aneurysm and initially considered to be a ventricular septal defect. However, further echocardiographic manipulation utilizing modified views along with sequential injections of both agitated saline and Definity proved very useful to identify a pseudoaneurysm.

Role of the surface electrocardiogram in developing countries.

The surface electrocardiogram (ECG) is a basic cardiac investigation delivering information not only regarding heart rhythm but also regarding ischemic disease, effects of hypertension, congenital syndromes, and cardiomyopathies. These may determine decisions regarding follow-up investigations or treatment. The ECG fulfils several characteristics of a good screening test: it is rapid, is noninvasive, requires minimal technical expertise to perform, and is inexpensive.

Implantable and surface electrocardiography: complementary technologies.

Combining information obtained from the surface electrocardiogram and implantable devices represents an emerging trend in electrocardiology. Important potential applications include ischemia detection and localization, continuous monitoring of cardiac cycle parameters, and telemedicine. This article presents an overview of these emerging applications, focusing on our recent studies that combine the electrograms obtained from body surface and implantable devices to reconstruct a full 12-lead electrocardiogram from the implanted device.

Quantification of plaque neovascularization using contrast ultrasound: a histologic validation.

Aims: The density of vasa vasorum within atherosclerotic plaque correlates with histologic features of plaque vulnerability in post-mortem studies. Imaging methods to non-invasively detect vasa vasorum are limited. We hypothesized that contrast ultrasound (CUS) can quantify vasa vasorum during atherosclerosis progression.

12-lead surface electrocardiogram reconstruction from implanted device electrograms.

Aim: Reconstruction of the surface electrocardiogram (EKG) from voltage recordings from implanted leads is not performed by current pacemakers or cardioverter-defibrillators. We investigated the feasibility and accuracy of reconstruction of a full 12-lead surface EKG from an implanted biventricular device.

Methods And Results: We applied three techniques for surface EKG reconstruction from multiple intracardiac (IC) vector recordings from implanted cardiac leads: single fixed dipole modelling via exact solution, exhaustive best-fit solution, and time-independent association using a transfer matrix.

Treatment options for refractory angina pectoris: enhanced external counterpulsation therapy.

Refractory angina pectoris, defined as angina refractory to maximal medical therapy and standard coronary revascularization procedures, remains a significant health problem in the United States and the world. Despite a panoply of recent therapeutic advances, patients with refractory angina pectoris are not adequately treated; therefore, scientists have been investigating new technologies to help these patients. The technique of counterpulsation, studied for almost half a century, is considered a safe, highly beneficial, low-cost, noninvasive treatment for these angina patients and now also for those with heart failure.

Persistence of left supracardinal vein in an adult patient with heart-hand syndrome and cardiac pacemaker.

A patient with a sporadic heart-hand syndrome, which includes thumb hypoplasia, septum primum atrial septal defect, and cleft mitral valve is described. During attempted placement of a pacemaker lead, persistence of left superior and inferior vena cava was found in addition to the right-sided caval veins. This corresponds to persistence of left-sided supracardinal vein present during fetal development.

Serial dobutamine stress echocardiography with Doppler assessment of the left internal thoracic artery graft after minimally invasive bypass for a patient with an orthotopic heart transplant.

Select patients who have undergone orthotopic heart transplantation with proximal left anterior disease may be candidates for minimally invasive direct coronary artery bypass surgery. Combining left internal thoracic artery transthoracic Doppler flow assessment with wall motion assessment during dobutamine stress echocardiography adds to the utility of this test by focusing attention on the graft's status as well as detecting ischemia due to cardiac allograft vasculopathy.

Is the presence of interatrial septal hypertrophy a marker for atrial fibrillation in the elderly?

Interatrial septal thickness (IST) appears to increase with heart weight, body surface area, and the presence of vacuolated fat cells within the atrial septum. The increased thickness of the atrial septum is an infrequently observed but readily recognized entity by echocardiography. Several reports have suggested that some cardiac arrhythmias, particularly those of atrial origin, may be a consequence of this fatty deposition.