Aortic intramural hematoma (IMH) has been accurately diagnosed by modern imaging techniques and may follow various clinical courses. We report a case in which 2 episodes of aortic IMH occurred in different aortic segments within a 10-month period. In the first episode the IMH involving the descending thoracic aorta regressed in 1 month; however, the large IMH involving the ascending and transverse aorta rapidly regressed within 24 hours in the second episode. The patient has been treated medically and is doing well.Clinical summary. The patient was a 62-year-old woman with a complicated history: removal of a pituitary adenoma in 1987, removal of the left kidney for renal cell carcinoma in 1992, and cerebral infarction in 1996. After removal of the pituitary adenoma she had been treated with hydrocortisone (30 mg/day) and desiccated thyroid (50 mg/day) for secondary adrenal hypofunction and hypothyroidism, respectively.
Biochemical and hemodynamic changes were assessed in 13 dogs subjected to sub-coronary valvular aortic stenosis and chronic protein-calorie malnutrition (PCM). Red blood cell, hemoglobin, serum albumin, free fatty acids, blood glucose, cholinesterase and blood amino acid levels were measured. The dynamic geometry of the left ventricle (LV) was assessed with chronically implanted sonomicrometric piezoelectric crystals. Cardiac function was evaluated by mean velocity of circumferential fiber shortening (mean VcF) and the relationship between LV end-systolic pressure (LVESP) or LV wall stress (LVWst) and LV end-systolic diameter (LVESD). The following results were obtained : 1) A decrease in body weight and increases in free fatty acids and 3-Methylhistidine were observed following long-term PCM. 2) Mean VcF was not depressed in dogs subjected to PCM. 3) The relationship between LVESP or LVWst and LVESD shipted downward and to the right after PCM, indicating reduced myocardial contractility. These findings suggest that the left ventricle in hypertrophied dog hearts subjected to PCM retains normal pump function, despite a low state in the myocardium.protein-calorie malnutrition ; sub-coronary aortic stenosis ; free acid ; 3-Methylhistidine ; myocardial contractility
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