Diagnosis of aortic valvular prolapse by echocardiography

Aortic valve aneurysm after acute endocarditis

Endocarditis at the aortic level is usually characterized by the presence of a vegetation or an abscess on echocardiography. This paper reports on what is believed by the authors to be the first case of endocarditis presenting as an aneurysmal deformation of one aortic cusp without a vegetation.

Echocardiographic features in spontaneous disruption of implanted tissue aortic valves

The echocardiographic features were recorded in three patients with spontaneous disruption of implanted tissue aortic valves. Two of the patients had xenografts, and one had a homograft. Aortic regurgitation had developed in all three spontaneously in the absence of active infective endocarditis. In each case there was severe disruption of the valve. Similar echocardiographic features have been found, usually in association with infective endocarditis or with myxomatous degeneration of the aortic valve. They have not previously been reported in association with implanted tissue aortic valves.

Comparison of echocardiography and angiography in determining the cause of severe aortic regurgitation

To assess the accuracy of echocardiography in determining the cause of aortic regurgitation M mode and cross sectional echocardiography were compared with angiography in 43 patients with predominant aortic regurgitation. Each patient had all three investigations performed during the same admission to hospital. In each instance, the cause of aortic regurgitation was confirmed at surgery or necropsy. Seventeen patients had rheumatic aortic valve disease, 13 bacterial endocarditis with a perforated or partially destroyed cusp, five a bicuspid aortic valve (four with a history of endocarditis), and eight aortic regurgitation secondary to aortic root dilatation or aneurysm. Overall sensitivity of echocardiography and aortography was 84% in determining the cause of aortic regurgitation. Thus, rheumatic valve disease and endocarditis appear to be the most common causes of severe aortic regurgitation in this hospital based population. Furthermore, echocardiography is a sensitive non-invasive technique for determining the cause of aortic regurgitation and allows differentiation of valvular from root causes of aortic regurgitation.

Anomalous chordae tendinae. A source of echocardiographic confusion

A unique instance of an anomalous chorda tendinae visualized in the left ventricular outflow tract during M-Mode and two-dimensional echocardiography, and subsequently confirmed during surgery for concomitant severe rheumatic valvular disease, is described. The M-Mode appearance can be confused with more serious forms of heart disease manifesting extraneous echoes in the outflow tract, and an approach to these echoes is described, based on a review of the literature.