A case of left ventricular fibroma in a symptomless 17-year-old girl is described. The tumour was extensive and after its removal inadequate left ventricular function resulted in death at operation. The role of surgical treatment is discussed.Primary tumours of the heart are rare (Prichard, 1951;Hudson, 1965;Heath, 1968) and particularly uncommon is the intramural ventricular fibroma; only 36 cases had been reported up to 1967 (Geha, Weidman, Soule, and McGoon, 1967). Most of these intramural fibromas were found in infants and young children at either necropsy or thoracotomy, but over the past 15 years the diagnosis has been made before operation and in a few patients successful surgical removal has been accomplished (Parks, Adams, and Longmire, 1962;Geha et al., 1967;Bjork, Dahlgren, Rudhe, Zetterqvist, 1967;Kay et al., 1968;Osano et al., 1969).Because of the rarity of these tumours Freeman, Geer, Randall, and Palfrey (1963) suggested that cases should be reported in order to increase knowledge of their natural history, diagnosis, and treatment. The case described here is that of a young girl with a large intramural fibroma of the left ventricle, diagnosed preoperatively, who died at operation. CASE REPORTThe patient, a 17-year-old girl, was referred to the Department of Cardiology, Royal Infirmary, Edinburgh, by her general practitioner who had detected a precordial systolic murmur at routine medical examination.She was asymptomatic and apart from common childhood illnesses her previous health had been excellent. On specific enquiry, however, she had noticed occasional 'missed beats' during the preceding few months.She was of average build with sinus arrhythmia and a systemic blood pressure of 115/60 mmHg. The jugular venous pulse was normal. There was no cardiomegaly and no thrill, but systolic pulsation was palpable at the upper left sternal edge. Heart sounds were normal with inspiratory splitting of the second heart sound and no accentuation of the pulmonary component. A short grade 2/6 mid-systolic murmur was heard in the pulmonary area but was not audible in the axillae or over the back. No ejection sound, diastolic murmur or other abnormal physical sign was detected.The electrocardiogram ( Fig. la and b) showed sinus arrhythmia with occasional ventricular extrasystoles and symmetrical inversion of the T waves in the high anterolateral leads. Her chest radiograph (Fig. 2) showed a localized bulge on the upper left heart border. Pulmonary arteries and pulmonary vascularity were normal. No calcification was detected at fluoroscopy. The full blood picture, blood urea, electrolytes, and plasma proteins were normal.At cardiac catheterization pressures and oxygen saturations on the right and left sides of the heart were normal. Cine-angiography, performed from the right and left ventricles, demonstrated a large mass encroaching on the outflow tract of both ventricles and displacing the interventricular septum to the right. The left atrium was also distorted and the left atrial appendage was not filled with c...
Accurate interpretation of an E .C .G. may provide valuable information on the assessment of a patient's cardiovascular system. Students, both undergraduate and postgraduate , may have to interpret an E.C.G. in the course of their daily ward duties or during a clinical examination and in this article emphasis is placed on the main diagnostic features of some of the more common E.C.G. abnormalities. Numerous books are available for more advanced study. The E.C.G. is particularly useful in the diagnosis of cardiac rhythm and myocardial infarction. It may reveal evidence of conduction defect, hypertrophy of the myocardium or pericarditis and may also indicate therapeutic response in certain electrolyte disturbances. On the other hand, non-specific E.C.G. changes are common.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.