Case Presentation. Federico Viganego, M.D. 1/19/07. Case 1-H.H. 61 y.o. M recently diagnosed with a right renal mass Presented to the hospital with progressive dyspnea and worsening renal function A 2D echo is ordered to evaluate the cause of dyspnea. Echocardiogram. Case 1-H.H. 2D ECHO.
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Federico Viganego, M.D.
Three types of cardiac masses:
Rheumatic mitral stenosis. There are severe valvular changes, including marked fibrosis and calcification of the mitral valve leaflets and severe chordal thickening and fusion into pillars of fibrous tissue.
(From Becker AE, Anderson RH [eds]: Cardiac Pathology: An Integrated Text and Colour Atlas.
New York, Raven Press, 1983, p 4.3.)
*valve gradients are flow dependent and when used to assess severity of valve
stenosis should be assessed with knowledge of cardiac output or forward flow across the valve.
Natural history of 159 patients with isolated mitral stenosis (solid blue line) or mitral regurgitation (solid purple line) who were not operated on (even though the operation was indicated) compared with patients treated with valve replacement for mitral stenosis (dashed blue line) or mitral regurgitation (dashed purple line). The expected survival rate in the absence of mitral valve disease is indicated by the upper curve (dashed black line).
(From Horstkotte D, Niehues R, Strauer BE: Pathomorphological aspects, aetiology, and natural history
of acquired mitral valve stenosis. Eur Heart J 12[Suppl]:55-60, 1991.)
(From Bach DS: Rheumatic mitral stenosis. N Engl J Med 337:31, 1997.)
ΔP= 4 v2