Symptomes and syndromes in dis_English_sem_6

The American Journal of Medicine, 1972

Internal and emergency medicine, 2013

A 47-year-old man admitted to our department with the persisting complaints of shortness of breath and dry cough. He had been treated with sulbactam-ampicillin with the diagnosis of pneumonia for 3 weeks. He began to define paroxysmal nocturnal dyspnea and orthopnea despite treatment for 4 days. On physical examination, he had an apical systolic murmur and fine crackles heard over the mid-upper chest. Electrocardiography demonstrated sinus rhythm with left atrial abnormality. Chest X-ray revealed bilateral symmetric pulmonary infiltration and pleural effusion with normal cardiac contours . Transthoracic echocardiography was obtained immediately and showed probable ruptured chorda tendineae resulting in severe mitral regurgitation with normal systolic functions. Further investigation with transesophageal echocardiography disclosed flail posterior mitral leaflet with eccentric mitral insufficiency jet flow directing to opposite site of affected leaflet . The patient responded well to mitral valve repair after an uneventful surgery.

The American Journal of Cardiology, 1973

Mediastinal fibrosis led to complete obstruction of the left main pulmonary artery and partial stenosis of the pulmonary artery to the right lower lobe in a 48 year old man. The lesion resulted in a high pressure pulmonary vascular system with an area of prolonged runoff through a low pressure vascular bed. Physical findings included a systolic murmur that radiated to the right hemithorax and a widely split second heart sound. The wide splitting was attributed to delay in deceleration of the column of blood due to partial stenosis of the pulmonary artery to the right lower lobe.