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Papillary Muscle Dysfunction


Presentation

  • No evidence of atherosclerosis or previous coronary arteritis was present.[ncbi.nlm.nih.gov]
  • Physical Examination Acute onset of hypotension is present.[wikidoc.org]
  • Presents comprehensive coverage of valvular heart disease to provide you with a complete reference and one-stop shop for this specialty in cardiac medicine.[books.google.com]
Congestive Heart Failure
  • A history of cardiogenic shock, acute congestive heart failure with cyanosis and atrioventricular murmur, or persistent fetal circulation in a newborn without congenital heart disease should alert the pathologist to the possibility of ischemic myocardial[ncbi.nlm.nih.gov]
  • Randomised, placebo-controlled trial of carvedilol in patients with congestive heart failure due to ischaemic heart disease. Lancet 1997; 349: 375-80. ‎[books.google.it]
  • The reduced left ventricular ejection fraction may lead to congestive heart failure and predispose to ventricular arrhythmias.[brown.edu]
  • Complications congestive heart failure pulmonary hypertension mass-effect from left atrial enlargement (e.g.[radiopaedia.org]
  • Tricuspid regurgitation (A) is another cause of a holosystolic murmur, however does not result from inferior infarction and does not commonly cause congestive heart failure.[healio.com]
Pathologist
  • A history of cardiogenic shock, acute congestive heart failure with cyanosis and atrioventricular murmur, or persistent fetal circulation in a newborn without congenital heart disease should alert the pathologist to the possibility of ischemic myocardial[ncbi.nlm.nih.gov]
Intermittent Claudication
  • claudication - Arteriovenous fistula - Hereditary hemorrhagic telangiectasia - Spider angioma - Dissection ( Carotid artery, Vertebral artery ) Veins, lymphatic vessels and lymph nodes Thrombosis / Phlebitis / Thrombophlebitis ( Deep vein thrombosis,[wikidoc.org]
Renal Artery Stenosis
  • artery stenosis ) - Aortic dissection / Aortic aneurysm ( Abdominal aortic aneurysm ) - Aneurysm - Raynaud's phenomenon / Raynaud's disease - Buerger's disease - Vasculitis / Arteritis ( Aortitis ) - Intermittent claudication - Arteriovenous fistula[wikidoc.org]
Pulmonary Valve Stenosis
  • valve ( stenosis, insufficiency ) - tricuspid valve ( stenosis, insufficiency ) Myocardium Myocarditis - Cardiomyopathy ( Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Loeffler endocarditis, Restrictive cardiomyopathy ) - Arrhythmogenic right[wikidoc.org]
Heart Disease
  • Their myocardial dysfunction and injury occurs with nearly equal frequency in both ventricles as a result of underperfusion from a wide range of causes, including severe birth asphyxia, congenital heart disease, and complications of premature delivery[ncbi.nlm.nih.gov]
  • Presents comprehensive coverage of valvular heart disease to provide you with a complete reference and one-stop shop for this specialty in cardiac medicine.[books.google.com]
  • […] hypertension ) Ischaemic heart disease Angina pectoris ( Prinzmetal's angina ) - Myocardial infarction (heart attack) - Dressler's syndrome Pulmonary circulation Pulmonary embolism - Cor pulmonale Pericardium Pericarditis - Pericardial effusion - Cardiac[wikidoc.org]
Systolic Murmur
  • Patients with systolic murmur had higher hospital and 1-year mortalities than those without systolic murmurs (p less than 0.01).[ncbi.nlm.nih.gov]
  • Absence of S4 with a late systolic murmur rules out the papillary muscle dysfunction.[notes.medicosnotes.com]
  • Papillary muscle dysfunction results in mitral regurgitation and an apical systolic murmur. The characteristics of the murmur vary depending upon the etiology of the papillary muscle dysfunction. In the case of FULL TEXT[annals.org]
  • Abstract Nine girls are presented with variable late systolic murmurs (usually best heard sitting up); five of the nine had mid systolic clicks, minimal to mild mitral regurgitation, and striking variable primary electrocardiographic T wave abnormalities[pediatrics.aappublications.org]
Tachycardia
  • […] branch block ( Left, Right ) - Bifascicular block - Trifascicular block Pre-excitation syndrome ( Wolff-Parkinson-White, Lown-Ganong-Levine ) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest - Sudden cardiac death Arrhythmia : Paroxysmal tachycardia[wikidoc.org]
  • tachycardia (VT), and ventricular fibrillation (VF).[msdmanuals.com]
  • Tachycardia ( overdrive pacing ) 13. Mechanical complications 1.[slideshare.net]
  • (PSVT)発作性上室性頻拍 paroxysmal ventricular tachycardia (PVT)発作性心室頻拍 patent ductus arteriosus (PDA) 動脈管開存[症] percardial friction rub心膜摩擦音 percussion 打診[法]、叩打法〈マッサージの一法〉 percutaneous transluminal coronaryangioplasty (PTCA)経皮的冠[状][動脈]形成[術] percutaneous transluminal[tokyo-med.ac.jp]
  • […] chronotropic I45.89 ICD-10-CM Diagnosis Code I45.89 Other specified conduction disorders 2016 2017 2018 2019 Billable/Specific Code Applicable To Atrioventricular [AV] dissociation Interference dissociation Isorhythmic dissociation Nonparoxysmal AV nodal tachycardia[icd10data.com]
Late Systolic Murmur
  • Absence of S4 with a late systolic murmur rules out the papillary muscle dysfunction.[notes.medicosnotes.com]
  • Abstract Nine girls are presented with variable late systolic murmurs (usually best heard sitting up); five of the nine had mid systolic clicks, minimal to mild mitral regurgitation, and striking variable primary electrocardiographic T wave abnormalities[pediatrics.aappublications.org]
  • Occasionally, only a late systolic murmur is found indicating that the papillary muscle functions in early systole but later demonstrates its ischemia-induced functional impairment in being unable to maintain the state of contraction to the end of systole[link.springer.com]
Late Systolic Murmur
  • Absence of S4 with a late systolic murmur rules out the papillary muscle dysfunction.[notes.medicosnotes.com]
  • Abstract Nine girls are presented with variable late systolic murmurs (usually best heard sitting up); five of the nine had mid systolic clicks, minimal to mild mitral regurgitation, and striking variable primary electrocardiographic T wave abnormalities[pediatrics.aappublications.org]
  • Occasionally, only a late systolic murmur is found indicating that the papillary muscle functions in early systole but later demonstrates its ischemia-induced functional impairment in being unable to maintain the state of contraction to the end of systole[link.springer.com]
Purpura
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]
Headache
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]
Encephalopathy
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]

Workup

Gastric Varices
  • varices, Caput medusae ) - Superior vena cava syndrome - Lymph ( Lymphadenitis, Lymphedema, Lymphangitis ) Other Hypotension ( Orthostatic hypotension ) - Rheumatic fever See also congenital ( Q20-Q28, 745-747 )[wikidoc.org]
Bifascicular Block
  • block - Trifascicular block Pre-excitation syndrome ( Wolff-Parkinson-White, Lown-Ganong-Levine ) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest - Sudden cardiac death Arrhythmia : Paroxysmal tachycardia ( Supraventricular, AV nodal reentrant[wikidoc.org]
T Wave Abnormality
  • Abstract Nine girls are presented with variable late systolic murmurs (usually best heard sitting up); five of the nine had mid systolic clicks, minimal to mild mitral regurgitation, and striking variable primary electrocardiographic T wave abnormalities[pediatrics.aappublications.org]

Treatment

  • Appropriate treatment is valve replacement rather than attempting conservative management.[ncbi.nlm.nih.gov]
  • Successful Early Surgical Treatment by Combined Mitral Valve Replacement and Aortocoronary Saphenous Vein Bypass Graft Abstract A patient with acute severe mitral regurgitation resulting from papillary muscle dysfunction which developed on the third day[circ.ahajournals.org]
  • Surgical treatment for symptoms produced by cervical ribs and the scalenus anticus muscle. Surg Gynecol Obstet 1947; 85: 687. ‏ الصفحة 234 - A general theory of the causes of murmurs in the cardiovascular system. ‏[books.google.com]

Prognosis

  • Widening the indications of surgery or angioplasty should result in an improvement of the prognosis of these high-risk patients.[ncbi.nlm.nih.gov]
  • The prognosis is believed to be good. Received November 29, 1967. Accepted January 24, 1968.[pediatrics.aappublications.org]
  • Prognosis [ 1 ] The best short-term and long-term results are obtained in asymptomatic patients operated on in specialist centres with low operative mortality ( 1%) and high repair rates ( 80-90%). [ 12 ] Acute MR is poorly tolerated and has a poor prognosis[patient.info]
  • By definition, patients in quadrant 4 are in "cardiogenic shock" and have a poor prognosis, unless they have a correctable mechanical complication, or unless they are early into the course of their MI, and some of the ischemic myocardium is recovered[brown.edu]
  • Restrictive mitral annuloplasty is the current treatment of choice, but it is associated with a 15% to 30% incidence of late recurrent mitral regurgitation, which confers a poor prognosis.[read.nxtbook.com]

Etiology

  • In type C (4 cases), pathological examinations disclosed various degrees of myocardial fibrosis, in which clinical diagnosis was MR of unknown etiology.[ncbi.nlm.nih.gov]
  • The characteristics of the murmur vary depending upon the etiology of the papillary muscle dysfunction. In the case of FULL TEXT[annals.org]
  • We believe that this syndrome is caused by posterior papillary muscle dysfunction, though the etiology, including the reason why only girls should be affected, is not known. The prognosis is believed to be good. Received November 29, 1967.[pediatrics.aappublications.org]
  • ., Ph.D. [2] Overview Related Key Words and Synonyms: Epidemiology and Demographics Pathophysiology & Etiology Left ventricular papillary muscles are perfused by the terminal portion of the coronary vascular bed, therefore, they are particularly vulnerable[wikidoc.org]
  • Introduction Etiology Prevention Complication Symptom Examine Diagnosis Treatment Basic Nursing Introduction Introduction to papillary muscle dysfunction Papillary muscle dysfunction refers to the atrioventricular valve tendon cord attached to the papillary[healthfrom.com]

Epidemiology

  • ., Ph.D. [2] Overview Related Key Words and Synonyms: Epidemiology and Demographics Pathophysiology & Etiology Left ventricular papillary muscles are perfused by the terminal portion of the coronary vascular bed, therefore, they are particularly vulnerable[wikidoc.org]
  • Epidemiology Trivial MR is frequent in healthy subjects.[patient.info]
  • […] s syndrome, rheumatoid arthritis Congenital heart disease – Atrioventricular canal defect Acute MR Myocardial Infarction (usually inferior) – rupture or dysfunction of papillary muscle Infective endocarditis Spontaneous rupture of a myxomatous chord Epidemiology[clinicaladvisor.com]
Sex distribution
Age distribution

Pathophysiology

  • ., Ph.D. [2] Overview Related Key Words and Synonyms: Epidemiology and Demographics Pathophysiology & Etiology Left ventricular papillary muscles are perfused by the terminal portion of the coronary vascular bed, therefore, they are particularly vulnerable[wikidoc.org]
  • Study limitations Ischemic MR includes a wide spectrum of underlying pathophysiologies, such as acute or chronic and global or segmental LV remodeling ( 6–21,35 ).[onlinejacc.org]
  • The severity of complications depends on the larger involvement of the chordae. ( More ruptured chordae causes more severe complications ) To explain the pathophysiological mechanism, lets consider that the ruptured chordae are those of the mitral valve[hmphysiology.blogspot.com]
  • A pathophysiology-guided approach to surgical repair is preferable, with a goal of alleviating leaflet tethering and restoring proper subvalvular mechanics.[read.nxtbook.com]
  • Pathophysiology Mitral incompetence is due to dysfunction of any one of the mitral annulus, mitral leaflets, chordae tendinae, or papillary muscles (see below). Chronic MR LV dilates with eccentric hypertrophy.[clinicaladvisor.com]

Prevention

  • […] objective evidence that de novo mitral regurgitation in patients with prior myocardial infarction is due to dyskinesis involving the left ventricular myocardium beneath one of the papillary muscles, producing increased tension on the mitral leaflets and preventing[ncbi.nlm.nih.gov]
  • Prevention Prevention of papillary muscle insufficiency (1) active use of various methods such as thrombolysis, emergency coronary angioplasty, bypass grafting, so that the occlusion of the coronary artery as soon as possible to save the dying heart,[healthfrom.com]
  • They attach to the cusps of the atrioventricular valves (also known as the mitral and tricuspid valves) via the chordae tendineae and contract to prevent inversion or prolapse of these valves on systole (or ventricular contraction). [1] The papillary[en.wikipedia.org]
  • Heart valve disease refers to any of several conditions that prevent one or more of the valves in the heart from functioning adequately to assure proper circulation.[my.clevelandclinic.org]

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