The diagnosis of pericardial effusion by echocardiography

106

Abstracts

cated,

(2) what type of valve should

placement,

be used for re-

and (3) what are the late complications

and results ? Although

more

were employed discontinued

than

200

between because

Teflon@

of frequent

This paper describes

primarily

dealt

primarily

with

with little

early deterioration.

employed

to

One hundred between

in

and thirteen

1966 and October

of 10%

2 patients

(3%},

infarction).

and

no

late

(2 homografts

and late

with coronary

ar-

In 32 patients between

1967 with no operative

valves

between

on

was an operative

disc valves were employed

transplant

report.

were operated

There

tery disease and myocardial

complication

valves were

present

late complications

(including

Kay-Suzuki

the

patients

ball valve.

of 2.6oj,,

deaths of 6%

Magovern

1964 and June 1966 with the use of

a Starr-Edwards mortality

and Magovern

included

February

and

have

of the use of disc valves.

Cutter

be

being

Most reports

Starr-Edwards

mention

Not enough SCDT

valves

valves currently

used in aortic valve replacement. valves,

leaflet

1960 and 1964, their use was

June

deaths, 1 late

deaths;

and

10

and 8 heterografts)

June 1966 and October

1967, with no opera-

The reduction

in late complications groups,

of time has elapsed, ened

incidence recent

is believed

associated

valves and the practice

period

period

to be due to the less-

of thromboembolism

disc and transplant more

and late deaths

even though a shorter

of concomitant

with

during this

myocardial

re-

The Diagnosis

of Pericardial

diography.

JACK

Pericardial A characteristic the moving effusion. min

Pericardial

bedside

during

with

with pericardial

surgery,

or

autopsy.

experimentally

experience.

separation

Localized

indicate

Disorders

BERNARD G.

and

not

fluid.

from the endocardial

majority

of se-

effusion,

from the moving

and the stationary

a

poste-

pericar-

of

Myocardial

Contraction.

KROHN, M.D., EDWARD DUNNE, M.D., HARVE

HANISH,

HAROLD K. TSUJI, M.D., J. V. REDINGTON, M.D. and JEROME

HAROLD

M.D., F.A.c.c., L,os Angeles,

KAY,

Calif. In 20 cases of arteriosclerotic ease a limited contract

portion

properly.

instead

During

of contracting,

was recorded

impedance

the

to

This

electrical

The

apparatus

changes

motion

that This

with the electrical

resistance

instantaneous

abnormal

blood

the aorta.

by cineangiography.

cardiogram. in

related The

accepting

through

bulge was also recorded

changes

heart dis-

wall failed to

systole this region dilated

thereby

should have been expelled phenomenon

and valvular

of the ventricular

measures

of the

thorax

heart

shape.

in

of the ventricular

wall

has

been called dyssynergy and also asynergy. In left ventricular

failure

during systole.

cle expanded ical shape.

excessively

dilated

diastole

and assumed

This robbed

that normally

the apex

During

para-

the ventri-

a more spher-

the apex of the small radius

allowed the thin apical muscle to sustain

of the

heart.

According

Radius.

Pressure

In 1

the separation

Another

to

La

= Muscle

Place’s

equation,

Tension

+

The apex would need to contract

strongly

Cavity

almost as

as the base to sustain the intracavitary

pres-

The

thin apical

It, therefore, palpable

muscle

stretched

ventricular

could not make in systole,

thrust.

that the base contracted

a sustained

Cinefluorograms

vigorously

revealed

in some cases, but

was low because diverted

this tension.

giving

the

paradoxically

blood and wasted work.

the

and by false

study was noted when a 3 cm. separation reflected

great

pericardial

OSCAR MAGIDSON, M.D., F.A.c.c.,

Comparison

wail of the heart was found to be caused thrombus

in

of fluid. pericarditis

wall

false positive

less often with in-

be demonstrated.

region

studies were encountered.

constrictive

the

massive

rior left ventricular dium should

output

to

In

with

Other

occur

of echoes reflected

dilating

pericardiocentesis

but should

patients

cardiac

anterior positive

creasing lected

sac by

the echoes arising from the pericardium

echoes

do occur

was of value at the

between organized

cm., and no effusion was found. studies

the pos-

was found to be 3

sure since the radius was almost the same in both areas.

by 1131 albu-

in the pericardial

The technic

of the removal

Two false positive

from

studies it was found that 50

cc. of fluid could be detected ultrasound.

reflected

was confirmed

effusion was also created In these animal

patient

wall thickness

Intracavitary

wall of the heart and stationary

diagnosis

reflected

in 28 patients

of echoes

pericardiocentesis,

completeness

terior left ventricular

wall was mis-

At autopsy,

as high a blood pressure as the thick muscle at the base

echocardiography.

can be found in patients The

by Echocar-

Pa.

was diagnosed presentation

separation

posterior

scan,

7 dogs.

Philadelphia,

effusion

with the aid of “B”

Effusion

J. KLEIN, M.D. and BERNARD L.

SEGAL, M.D., F.A.c.c.,

pericardium

effusion.

doxically

vascularization.

left ventricular

taken for pericardial

paradoxic

tive deaths and 2 late complications. in the two latter

surfaces of the posterior

and epicardial

of

of

Metabolic phrine

Effects

the

Hemodynamic

in Experimental

tion with

Shock.

and

of Isoproterenol Acute

LESLIE

and

Myocardial

A. KUHN,

s equential alterations

KLEIN, M.D., New York,

hemodynamic were

determined

and in

Infarc-

M.D., F.A.c.c., M.D.

HOWARDJ.KLINE,M.D.,STEPHENRICHMOND, LAWRENCE

Cardiac

Norepine-

and

N. Y. cardiac 12

THE AMERICANJOURNALOF

metabolic

dogs

receiving

CARDIOLOGY