Document Detail

An adult case with an abnormal right ventricular structure causing intraventricular pressure gradient and a history of aphthous stomatitis and thrombophlebitis.
MedLine Citation:
PMID:  10611919     Owner:  NLM     Status:  MEDLINE    
We report a 50-year-old man with a right ventricular structure causing an intraventricular pressure gradient. He had been diagnosed as vasculo-Behçet with a history of aphthous stomatitis and thrombophlebitis. He had also been suffering from atrial flutter and mild right-side heart failure. Echocardiography showed that there was an abnormal structure attached to the right ventricular free wall and protruding into the cavity, and that it caused the pressure gradient estimated to be approximately 19 mmHg. Chest X-ray computed tomography demonstrated that the structure was partially calcified. Magnetic resonance imaging depicted the structure separating the right ventricle into two chambers. Angiographic study revealed a markedly enlarged right atrium and a filling defect at the mid-portion of the right ventricle, which divided the right ventricular cavity into two parts. Hemodynamic study showed a slightly elevated right atrial pressure (mean 7 mmHg) and a peak-to-peak intraventricular pressure difference of 18 mmHg in the right ventricle. The diastolic pressure tracing of the right ventricular low pressure chamber showed a 'dip and plateau' pattern. Although the pathological features of the abnormal right ventricular structure in this case were not fully clarified, abnormal muscle bundle and/or endocardial fibrosis, which were reported to be associated with Behçet's disease, may have contributed to its generation.
Y Sugishita; S Tajima; T Shimizu; K Sugishita; K Harada; H Matsui; M Inoue; Y Murakawa; J Suzuki; K Takenaka; M Omata; T Takahashi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Japanese heart journal     Volume:  40     ISSN:  0021-4868     ISO Abbreviation:  Jpn Heart J     Publication Date:  1999 Jul 
Date Detail:
Created Date:  2000-01-05     Completed Date:  2000-01-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401175     Medline TA:  Jpn Heart J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  517-25     Citation Subset:  IM    
Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.
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MeSH Terms
Atrial Flutter / etiology
Behcet Syndrome / complications*
Diagnosis, Differential
Heart Failure / etiology
Heart Ventricles / abnormalities*,  pathology,  ultrasonography
Magnetic Resonance Imaging
Middle Aged
Stomatitis, Aphthous / complications*
Thrombophlebitis / complications*
Ventricular Pressure*

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