Anatomic Variants Mimicking Pathology on Echocardiography: Differential Diagnosis

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Differentiation of normal from abnormal findings is critical in echocardiography. Anatomic variants occurring in normal cardiac developments often simulate pathologic entities. This review focuses on the differential diagnosis of normal anatomic structures from pathologic ones in echocardiography.

Related collections

Most cited references 43

Record: found
Abstract: found
Article: not found

Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases.

Ramesh Gowda, Ijaz Khan, Chandra Nair … (2003)

With the advent of echocardiography, cardiac papillary fibroelastoma (CPF) is being increasingly reported. The demographics, clinical characteristics, pathological features, treatment, and prognosis of CPF are examined. Cases, case series and related articles on the subject in all languages were identified through a comprehensive literature search. Seven hundred twenty-five cases of CPF were identified. Males comprised 55% of patients. Highest prevalence was in the 8th decade of life. The valvular surface was the predominant locations of tumor. The most commonly involved valve was the aortic valve, followed by the mitral valve. The left ventricle was the predominant nonvalvular site involved. No clear risk factor for development of CPF has been reported. Size of the tumor varied from 2 mm to 70 mm. Clinically, CPFs have presented with transient ischemic attack, stroke, myocardial infarction, sudden death, heart failure, presyncope, syncope, pulmonary embolism, blindness, and peripheral embolism. Tumor mobility was the only independent predictor of CPF-related death or nonfatal embolization. Symptomatic patients should be treated surgically because the successful complete resection of CPF is curative and the long-term postoperative prognosis is excellent. The symptomatic patients who are not surgical candidates could be offered long-term oral anticoagulation, although no randomized controlled data are available on its efficacy. Asymptomatic patients could be treated surgically if the tumor is mobile, as the tumor mobility is the independent predictor of death or nonfatal embolization. Asymptomatic patients with nonmobile CPF could be followed-up closely with periodic clinical evaluation and echocardiography, and receive surgical intervention when symptoms develop or the tumor becomes mobile.

0 comments Cited 166 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation.

Kyle Klarich, Maurice Enriquez-Sarano, George M. Gura … (1997)

We sought to determine the clinical and echocardiographic characteristics of papillary fibroelastoma (PFE). PFE is a rarely encountered cardiac tumor about which relatively little is known. Institutional records were reviewed for the years 1980 to 1995 for patients with pathologic or echocardiographic diagnosis of PFE. Group 1 included 17 patients with the pathologic diagnosis of PFE who also underwent echocardiography. Echocardiographic features of PFE were established in group 1. Group 2 included 37 patients with only echocardiographic evidence of PFE. In group 1, 7 (41.2%) of 17 patients had symptoms related to PFE. Neurologic events occurred in 5 (29.4%) of 17 patients. All patients had the tumor surgically removed. During follow-up, no new embolic events occurred. Echocardiographic characteristics of PFE included a small tumor (12.1 +/- 6.5 x 9.0 +/- 4.3 mm), usually pedunculated (14 [94%] of 17 patients) and mobile, with a homogeneous speckled pattern and a characteristic stippling along the edges. PFEs were most common on valvular surfaces (12 [60%] of 20 PFEs) but were not uncommon on other endocardial surfaces (8 [40%] of 20 PFEs). The tumor did not cause valvular dysfunction. In group 2, 16 (43%) of 37 patients were asymptomatic. Five patients (13.5%) had a previous neurologic event. During follow-up (mean 31 months, range 1 to 77), nine neurologic events occurred. PFEs are associated with embolism, can be diagnosed with echocardiography, are often an incidental clinical finding and do not cause valvular dysfunction.

0 comments Cited 58 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Diagnosis and classification of atrial septal aneurysm by two-dimensional echocardiography: report of 80 consecutive cases.

Peter Hanley, A Tajik, John Hynes … (1985)

Atrial septal aneurysms have been related (either by association or as potential causes) to systolic clicks, atrial arrhythmias, systemic and pulmonary embolism, atrioventricular valve prolapse and atrial septal defect. To study these associations and the incidence of atrial septal aneurysm, we reviewed 80 consecutive patients (female to male ratio 1.9:1, mean age 47 years, range 1 day to 89 years) who had been identified prospectively as having an atrial septal aneurysm. These were found in 36,200 two-dimensional echocardiographic studies (incidence: 0.22% overall; 0.29% in the last year of the study done between 1978 and 1984). Three types of fossa ovalis aneurysm and one type of aneurysm involving the entire atrial septum were observed; a fossa ovalis aneurysm with leftward projection and excursion of less than 5 mm or an aneurysm involving the entire atrial septum with rightward projection was not observed. Atrial septal aneurysm occurred more often as an isolated abnormality than in association with other cardiac malformations, although all patients with an aneurysm involving the entire atrial septum had complex congenital cardiac anomalies of the hypoplastic right heart type. The reported associations between atrial septal aneurysms and atrial septal defect, atrioventricular valve prolapse, midsystolic clicks, atrial arrhythmias and cerebral ischemic events were examined. A hypothesis based on interatrial pressure gradients is proposed to explain the different motions and configurational characteristics of fossa ovalis aneurysms observed in these patients. All patients in whom atrial septal aneurysm is demonstrated should undergo examination for atrial septal defect. Atrial septal aneurysm should be specifically looked for in patients who have these associations and who undergo two-dimensional echocardiography, especially if these abnormalities are unexplained.

0 comments Cited 49 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): J Cardiovasc Ultrasound

Journal ID (iso-abbrev): J Cardiovasc Ultrasound

Journal ID (publisher-id): JCU

Title: Journal of Cardiovascular Ultrasound

Publisher: Korean Society of Echocardiography

ISSN (Print): 1975-4612

ISSN (Electronic): 2005-9655

Publication date (Print): September 2013

Publication date (Electronic): 30 September 2013

Volume: 21

Issue: 3

Pages: 103-112

Affiliations

Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Author notes

Address for Correspondence: Hae Ok Jung, Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-6033, Fax: +82-2-591-1506, hojheart@ 123456catholic.ac.kr

Article

DOI: 10.4250/jcu.2013.21.3.103

PMC ID: 3816159

SO-VID: 56d4a5ab-bf1b-49f0-8885-4b70c4b783a6

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 23 August 2013

Date revision received : 17 September 2013

Date accepted : 17 September 2013

Comments

Comment on this article

scite_

Cited by 14

See all cited by

Most referenced authors 285

See all reference authors

Anatomic Variants Mimicking Pathology on Echocardiography: Differential Diagnosis

Read this article at

Abstract

Related collections

Karger: Cardiovascular System

Most cited references 43

Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases.

Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation.

Diagnosis and classification of atrial septal aneurysm by two-dimensional echocardiography: report of 80 consecutive cases.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 102

Cited by 14

Most referenced authors 285