Negro R, Russo L, Aloisi B, Grasso V, Russo G, Grassi R
G Ital Cardiol. 1981;11(12):2239-43.
The authors correlate echocardiographic and haemodynamic reports of a 12 year old patient with congestive heart failure and enlarged heart, secondary to fibrotic cardiomyopathy which effected the right ventricle (RV) and left ventricle (LV) apex. The echocardiographic M-mode examination showed: dilatation of the RV; ectasis and akinesis of the apex of the LV; the left auricle small for hypoafflux; tricuspid valve very noticeable with defective end-diastolic closure, delayed 0,80 msec as regards to the mitral valve, and in which it was not possible to identify the proto-diastolic opening; typical movement of the pulmonary valve, according to French's description, with synchronous opening to the atrial systole; paradoxical movement of septum, with the peculiarity of showing the maximum posterior movement relating to the atrial systole. Catheterism indicated same pressures in the right auricle, RV and pulmonary artery, as is typical of right ventricle ipoplastic. Angiography confirmed echocardiographic reports revealing an enlarged right auricle and an ectasic and akinetic RV; the tricuspid valve was normally established and it remained almost constantly open; the apex of the LV was ectasic and akinetic. In conclusion, for the akinesis of the RV, the blood flow in the pulmonary artery was secured by atrial systole; such a haemodynamic situation had already been indicated by the echocardiographic examination for the absence of the real systolic closure of the tricuspid valve that the authors indicate as the most characteristic sign of such a table, together with the opening of the pulmonary valve with atrial systole.
