Asymptomatic accessory mitral valve tissue diagnosed by echocardiography/Ekokardiyografi ile teshis edilmis bir asemptomatik aksesuvar mitral kapak dokusu olgusu.A 52-year-old man was referred to our hospital because of an apical first degree pansystolic murmur heard on routine cardiac examination. The patient was free of cardiac symptoms and his electrocardiogram and telecardiogram showed no pathology. Transthoracic echocardiography showed cyst-like formation on the anterolateral anterolateral /an·tero·lat·er·al/ (an?ter-o-lat´er-al) situated anteriorly and to one side. an·ter·o·lat·er·al adj. In front and away from the middle line. mitral mitral /mi·tral/ (mi´tril) shaped like a miter; pertaining to the mitral valve. mi·tral adj. 1. Relating to a mitral valve. 2. Shaped like a bishop's miter. chordae without pressure gradient across the mitral valve and subaortic region (Fig. 1, 2). Transesophageal echocardiography demonstrated this formation was an accessory mitral valve tissue with a mild regurgitation regurgitation /re·gur·gi·ta·tion/ (re-ger?ji-ta´shun) 1. flow in the opposite direction from normal. 2. vomiting. (Video 1. See corresponding video/movie images at www.anakarder.com). The surgical procedure was not considered and it was decided that the patient would be followed by periodical echocardiographic examinations and aspirin was prescribed. The accessory mitral valve tissue (AcMV) is an anomaly of embryological development of the endocardial cushion. The accessory mitral valve is usually associated with complex cardiac congenital malformations and very rarely seen as an isolated congenital anomaly. The most common clinical presentation is symptomatic left ventricular outflow tract A ventricular outflow tract is a portion of either the left or right ventricle of the human heart through which blood passes in order to enter the great arteries. The right outflow tract is an infundibular extension of the ventricular cavity, which connects to the pulmonary (LVOT) obstruction occurring as a result of mass effect in the early years of life or progressing gradually due to the continued accumulation of fibrous tissue within the LVOT and generally becomes symptomatic as dyspnea on exertion dyspnea on exertion Cardiology Shortness of breath which occurs with effort, often a sign of heart failure or ischemia , chest pain, syncope syncope Effect of temporary impairment of blood circulation to a part of the body. It is often used as a synonym for fainting, which is loss of consciousness due to inadequate blood flow to the brain. or very rarely cerebrovascular accident. Echocardiography Echocardiography Definition Echocardiography is a diagnostic test that uses ultrasound waves to create an image of the heart muscle. Ultrasound waves that rebound or echo off the heart can show the size, shape, and movement of the heart's valves and is a useful diagnostic tool for an accurate visualization. Patients with AcMV causing considerable LVOT obstruction should be operated, however prophylactic removal should not be attempted in patients with no or mild obstruction and no other associated congenital anomalies. These patients should be followed by periodical echocardiographic examinations for catching any change in the LVOT obstruction. [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] Senay Funda Biyikoglu, Yesim Guray, Sezgin Ozturk, Omac Tufekgioglu Department of Cardiology Yuksek Ihtisas Hospital, Ankara, Turkey Address for Correspondence/Yazisma Adresi: Dr. Senay Funda Biyikoglu Turkiye Yuksek Ihtisas Hastanesi, Kardiyoloji, Ankara, Turkiye Phone: +90 312 30611 29 Fax: +90 312 312 41 20 E-mail: fundabiyikoglu@yahoo.com |
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