Hemodynamic consequences of left atrial myxomas as assessed by Doppler ultrasound

Seven patients with left atrial (LA) myxoma who were studied by M-mode, two-dimensional, and Doppler echocardiography and who underwent surgical excision of the tumor are described. In six patients, the myxoma was attached to the lower interatrial septum and was protruding through the mitral valve (MV) during diastole. Significant MV obstruction (mean diastolic gradient of 16 mm Hg) was detected by Doppler in only one patient and was confirmed by hemodynamic studies; another patient had only a small gradient (peak 8 and mean 4 mm Hg). Mild mitral regurgitation (MR) was found preoperatively in four of five patients who underwent left ventriculography, but was not detected by Doppler. Postoperatively, however, five patients were found to have mild MR and one patient had moderate MR by Doppler. The use of Doppler echocardiography can provide important additional information regarding the hemodynamic consequences of LA myxomas.

Prevalence and severity of mitral regurgitation in the mitral valve prolapse syndrome: a Doppler echocardiographic study of 80 patients

Doppler echocardiography was performed in 80 consecutive patients (22 men, 58 women), aged 38 +/- 16 years, who had mitral valve prolapse diagnosed by two-dimensional echocardiography. Of the 80 patients, 16 (20%) were asymptomatic and 11 (14%) had a normal physical examination (no click or murmur). The M-mode echocardiogram was negative for mitral valve prolapse in 11 patients (14%) and equivocal or nondiagnostic in 19 patients (24%). Mitral regurgitation was evaluated using pulsed mode Doppler echocardiography and was quantified by the mapping technique as minimal or mild when a holosystolic regurgitant jet was recorded just below the mitral valve into the left atrium, and as moderate or severe when the jet was detected at the mid- or distal left atrium. Mitral regurgitation was found in 55 (69%) of the 80 patients and it was minimal or mild in 47 patients (59%) and moderate or severe in 8 (10%). In 20 (36%) of the 55 patients with mitral regurgitation by Doppler technique, a systolic murmur was not detected and each of the 20 had only mild mitral regurgitation. Left atrial and left ventricular size were significantly smaller in patients with mild or no regurgitation as compared with the eight patients with moderate or severe regurgitation. These eight patients were all men (six over 50 years of age) who usually presented with dyspnea and a holosystolic murmur; the mitral valve prolapse was holosystolic by M-mode and involved both leaflets by two-dimensional echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)