The Experts below are selected from a list of 285 Experts worldwide ranked by ideXlab platform
Yoshio Kobayashi - One of the best experts on this subject based on the ideXlab platform.
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Bland-White-Garland syndrome diagnosed by computed tomography.
International journal of cardiology, 2015Co-Authors: Nobusada Funabashi, Keishi Ishikawa, Koya Ozawa, Hiroyuki Takaoka, Naoki Shimojo, Yoshio KobayashiAbstract:A seven year old girl was referred to our pediatric clinic with an abnormal cardiac Murmur found during her school medical examination. She was asymptomatic. It was diagnosed as a Functional Murmur but transthoracic echocardiography (TTE) revealed enlarged left main trunk (LMT) (4.8 mm) and right coronary artery (RCA) (5.8 mm) (Fig. 1). Kawasaki disease was suspected and she was referred to our hospital for an invasive coronary angiogram. She and her family opted first for non invasive imaging by electrocardiogram gated 320 slice CT. In CT acquisition, triple phase contrast material injection was performed using 40 ml of iodinated contrast material (300 mgI/ml) followed by 20 ml saline to enhance left (highly enhanced) and right (slightly enhanced) heart to simultaneously examine the coronary arteries and detect any other congenital heart disease. We used 240, instead of the full 320, detector rows to reduce radiation exposure. Tube voltage was 100 kV and tube current was set at 200 mV. Despite administration of β-blockers, her heart rate (HR) only decreased to 70 beats per minute (bpm). To image her heart, we used a HeartNAVI® system (Toshiba), with a temporal resolution that can be optimized according to the HR during scanning. CT images are usually reconstructed using data from 2 heart beats for subjects with HR's from 66 to 79 bpm. We amended this procedure to reduce radiation exposure; retrospective ECG acquisition was performed with tube current modulation using data from only one heartbeat. CT images were reconstructed every 5% from 0 to 95% of the RR interval. We assessed images using data from all 20 phases and the best optimal phase images were selected manually (Figs. 2–6). On CT, an enlarged RCA with several well-developed, abnormal septal branches were observed (Figs. 2, 4, 5). Also the LMT originated from the pulmonary trunk (PT) (Figs. 3, 5) and blood flow from LMT to PT (Fig. 6) could be observed.
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AN ANOMALOUS LEFT CORONARY ARTERY BRANCHING OFF THE PULMONARY ARTERY (BLAND-WHITE-GARLAND SYNDROME) DIAGNOSED BY 320 DETECTOR ROWS COMPUTED TOMOGRAPHY
Journal of the American College of Cardiology, 2015Co-Authors: Keishi Ishikawa, Nobusada Funabashi, Koya Ozawa, Hiroyuki Takaoka, Yoshio KobayashiAbstract:If enlarged coronary arteries are observed in infants, we must first differentiate between Kawasaki disease, and arteritis. A seven year old girl was referred to our hospital with an abnormal cardiac Murmur found at her school medical examination. It was diagnosed as a Functional Murmur but a
Keishi Ishikawa - One of the best experts on this subject based on the ideXlab platform.
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Bland-White-Garland syndrome diagnosed by computed tomography.
International journal of cardiology, 2015Co-Authors: Nobusada Funabashi, Keishi Ishikawa, Koya Ozawa, Hiroyuki Takaoka, Naoki Shimojo, Yoshio KobayashiAbstract:A seven year old girl was referred to our pediatric clinic with an abnormal cardiac Murmur found during her school medical examination. She was asymptomatic. It was diagnosed as a Functional Murmur but transthoracic echocardiography (TTE) revealed enlarged left main trunk (LMT) (4.8 mm) and right coronary artery (RCA) (5.8 mm) (Fig. 1). Kawasaki disease was suspected and she was referred to our hospital for an invasive coronary angiogram. She and her family opted first for non invasive imaging by electrocardiogram gated 320 slice CT. In CT acquisition, triple phase contrast material injection was performed using 40 ml of iodinated contrast material (300 mgI/ml) followed by 20 ml saline to enhance left (highly enhanced) and right (slightly enhanced) heart to simultaneously examine the coronary arteries and detect any other congenital heart disease. We used 240, instead of the full 320, detector rows to reduce radiation exposure. Tube voltage was 100 kV and tube current was set at 200 mV. Despite administration of β-blockers, her heart rate (HR) only decreased to 70 beats per minute (bpm). To image her heart, we used a HeartNAVI® system (Toshiba), with a temporal resolution that can be optimized according to the HR during scanning. CT images are usually reconstructed using data from 2 heart beats for subjects with HR's from 66 to 79 bpm. We amended this procedure to reduce radiation exposure; retrospective ECG acquisition was performed with tube current modulation using data from only one heartbeat. CT images were reconstructed every 5% from 0 to 95% of the RR interval. We assessed images using data from all 20 phases and the best optimal phase images were selected manually (Figs. 2–6). On CT, an enlarged RCA with several well-developed, abnormal septal branches were observed (Figs. 2, 4, 5). Also the LMT originated from the pulmonary trunk (PT) (Figs. 3, 5) and blood flow from LMT to PT (Fig. 6) could be observed.
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AN ANOMALOUS LEFT CORONARY ARTERY BRANCHING OFF THE PULMONARY ARTERY (BLAND-WHITE-GARLAND SYNDROME) DIAGNOSED BY 320 DETECTOR ROWS COMPUTED TOMOGRAPHY
Journal of the American College of Cardiology, 2015Co-Authors: Keishi Ishikawa, Nobusada Funabashi, Koya Ozawa, Hiroyuki Takaoka, Yoshio KobayashiAbstract:If enlarged coronary arteries are observed in infants, we must first differentiate between Kawasaki disease, and arteritis. A seven year old girl was referred to our hospital with an abnormal cardiac Murmur found at her school medical examination. It was diagnosed as a Functional Murmur but a
Nobusada Funabashi - One of the best experts on this subject based on the ideXlab platform.
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Bland-White-Garland syndrome diagnosed by computed tomography.
International journal of cardiology, 2015Co-Authors: Nobusada Funabashi, Keishi Ishikawa, Koya Ozawa, Hiroyuki Takaoka, Naoki Shimojo, Yoshio KobayashiAbstract:A seven year old girl was referred to our pediatric clinic with an abnormal cardiac Murmur found during her school medical examination. She was asymptomatic. It was diagnosed as a Functional Murmur but transthoracic echocardiography (TTE) revealed enlarged left main trunk (LMT) (4.8 mm) and right coronary artery (RCA) (5.8 mm) (Fig. 1). Kawasaki disease was suspected and she was referred to our hospital for an invasive coronary angiogram. She and her family opted first for non invasive imaging by electrocardiogram gated 320 slice CT. In CT acquisition, triple phase contrast material injection was performed using 40 ml of iodinated contrast material (300 mgI/ml) followed by 20 ml saline to enhance left (highly enhanced) and right (slightly enhanced) heart to simultaneously examine the coronary arteries and detect any other congenital heart disease. We used 240, instead of the full 320, detector rows to reduce radiation exposure. Tube voltage was 100 kV and tube current was set at 200 mV. Despite administration of β-blockers, her heart rate (HR) only decreased to 70 beats per minute (bpm). To image her heart, we used a HeartNAVI® system (Toshiba), with a temporal resolution that can be optimized according to the HR during scanning. CT images are usually reconstructed using data from 2 heart beats for subjects with HR's from 66 to 79 bpm. We amended this procedure to reduce radiation exposure; retrospective ECG acquisition was performed with tube current modulation using data from only one heartbeat. CT images were reconstructed every 5% from 0 to 95% of the RR interval. We assessed images using data from all 20 phases and the best optimal phase images were selected manually (Figs. 2–6). On CT, an enlarged RCA with several well-developed, abnormal septal branches were observed (Figs. 2, 4, 5). Also the LMT originated from the pulmonary trunk (PT) (Figs. 3, 5) and blood flow from LMT to PT (Fig. 6) could be observed.
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AN ANOMALOUS LEFT CORONARY ARTERY BRANCHING OFF THE PULMONARY ARTERY (BLAND-WHITE-GARLAND SYNDROME) DIAGNOSED BY 320 DETECTOR ROWS COMPUTED TOMOGRAPHY
Journal of the American College of Cardiology, 2015Co-Authors: Keishi Ishikawa, Nobusada Funabashi, Koya Ozawa, Hiroyuki Takaoka, Yoshio KobayashiAbstract:If enlarged coronary arteries are observed in infants, we must first differentiate between Kawasaki disease, and arteritis. A seven year old girl was referred to our hospital with an abnormal cardiac Murmur found at her school medical examination. It was diagnosed as a Functional Murmur but a
Rolf Jenni - One of the best experts on this subject based on the ideXlab platform.
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Echocardiography in the evaluation of systolic Murmurs of unknown cause.
The American journal of medicine, 2000Co-Authors: Christine H. Attenhofer Jost, Juraj Turina, Kurt Mayer, Burkhardt Seifert, F. Wolfgang Amann, Martin Buechi, Marco Facchini, Hans-peter Brunner-la Rocca, Rolf JenniAbstract:Abstract PURPOSE: Systolic Murmurs are common, and it is important to know whether physical examination can reliably determine their cause. Therefore, we prospectively assessed the diagnostic accuracy of a cardiac examination in patients without previous echocardiography who were referred for evaluation of a systolic Murmur. SUBJECTS AND METHODS: In 100 consecutive adults (mean [± SD] age of 58 ± 22 years) who were referred for a systolic Murmur of unknown cause, the diagnostic accuracy of the cardiac examination by cardiologists (without provision of clinical history, electrocardiogram, or chest radiograph) was compared with the results of echocardiography. RESULTS: The echocardiographic findings included a normal examination (Functional Murmur) in 21 patients, aortic stenosis in 29 patients, mitral regurgitation in 30 patients, left or right intraventricular pressure gradient in 11 patients, mitral valve prolapse in 11 patients, ventricular septal defect in 4 patients, hypertrophic obstructive cardiomyopathy in 3 patients, and associated aortic regurgitation in 28 patients. In 28 (35%) of the 79 patients with organic heart disease, more than one abnormality was found; combined aortic and mitral valve disease was the most frequent combination (n = 22). The sensitivity of the cardiac examination was acceptable for detecting ventricular septal defect (100% [4 of 4]), isolated mitral regurgitation (88% [26 of 36]), aortic stenosis (71% [21 of 29]), and a Functional Murmur (67% [14 of 21]), but not for intraventricular pressure gradients (18% [2 of 11]), aortic regurgitation (21% [6 of 28]), combined aortic and mitral valve disease (55% [6 of 11]), and mitral valve prolapse (55% [12 of 22]). In 6 patients, the degree of aortic stenosis was misjudged on the clinical examination, mainly because of a severely diminished left ventricular ejection fraction. Significant heart disease was missed completely in only 2 patients. CONCLUSION: In adults with a systolic Murmur of unknown cause, a Functional Murmur can usually be distinguished from an organic Murmur. However, the ability of the cardiac examination to assess the exact cause of the Murmur is limited, especially if more than one lesion is present. Thus, echocardiography should be performed in patients with systolic Murmurs of unknown cause who are suspected of having significant heart disease.
Koya Ozawa - One of the best experts on this subject based on the ideXlab platform.
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Bland-White-Garland syndrome diagnosed by computed tomography.
International journal of cardiology, 2015Co-Authors: Nobusada Funabashi, Keishi Ishikawa, Koya Ozawa, Hiroyuki Takaoka, Naoki Shimojo, Yoshio KobayashiAbstract:A seven year old girl was referred to our pediatric clinic with an abnormal cardiac Murmur found during her school medical examination. She was asymptomatic. It was diagnosed as a Functional Murmur but transthoracic echocardiography (TTE) revealed enlarged left main trunk (LMT) (4.8 mm) and right coronary artery (RCA) (5.8 mm) (Fig. 1). Kawasaki disease was suspected and she was referred to our hospital for an invasive coronary angiogram. She and her family opted first for non invasive imaging by electrocardiogram gated 320 slice CT. In CT acquisition, triple phase contrast material injection was performed using 40 ml of iodinated contrast material (300 mgI/ml) followed by 20 ml saline to enhance left (highly enhanced) and right (slightly enhanced) heart to simultaneously examine the coronary arteries and detect any other congenital heart disease. We used 240, instead of the full 320, detector rows to reduce radiation exposure. Tube voltage was 100 kV and tube current was set at 200 mV. Despite administration of β-blockers, her heart rate (HR) only decreased to 70 beats per minute (bpm). To image her heart, we used a HeartNAVI® system (Toshiba), with a temporal resolution that can be optimized according to the HR during scanning. CT images are usually reconstructed using data from 2 heart beats for subjects with HR's from 66 to 79 bpm. We amended this procedure to reduce radiation exposure; retrospective ECG acquisition was performed with tube current modulation using data from only one heartbeat. CT images were reconstructed every 5% from 0 to 95% of the RR interval. We assessed images using data from all 20 phases and the best optimal phase images were selected manually (Figs. 2–6). On CT, an enlarged RCA with several well-developed, abnormal septal branches were observed (Figs. 2, 4, 5). Also the LMT originated from the pulmonary trunk (PT) (Figs. 3, 5) and blood flow from LMT to PT (Fig. 6) could be observed.
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AN ANOMALOUS LEFT CORONARY ARTERY BRANCHING OFF THE PULMONARY ARTERY (BLAND-WHITE-GARLAND SYNDROME) DIAGNOSED BY 320 DETECTOR ROWS COMPUTED TOMOGRAPHY
Journal of the American College of Cardiology, 2015Co-Authors: Keishi Ishikawa, Nobusada Funabashi, Koya Ozawa, Hiroyuki Takaoka, Yoshio KobayashiAbstract:If enlarged coronary arteries are observed in infants, we must first differentiate between Kawasaki disease, and arteritis. A seven year old girl was referred to our hospital with an abnormal cardiac Murmur found at her school medical examination. It was diagnosed as a Functional Murmur but a
