Acute Heart Failure in a Patient with Occult Barlow’s Disease Receiving Bevacizumab

Bevacizumab is a recombinant humanized monoclonal antibody and a key drug for treatment of various types of cancer. Bevacizumab is associated with the occurrence of heart failure, but its risk factors remain unknown. A 55-year-old woman was diagnosed with cervical cancer, which was completely treated by bevacizumab-incorporated chemotherapy. During the 9-month bevacizumab therapy, she suffered from hypertension requiring multiple antihypertensive agents. She was admitted to our hospital due to acute heart failure with afterload mismatch and severe mitral regurgitation. A transesophageal echocardiography showed Barlow’s disease with a degenerated and widely prolapsed mitral valve. She received a scheduled surgical mitral valve repair. Post-operative cause was uneventful, but metastatic dissemination developed later. The existence of mitral valve regurgitation, even when sub-clinical, might be a risk of worsening heart failure during bevacizumab therapy. Careful follow-up at an onco-cardiology clinic is highly encouraged particularly for such a cohort during bevacizumab therapy.

Sonogram features of myxomatous mitral valve disease and abdominal organ dissorders in a senior mini pomeranian

A 12-years-old mini pomeranian with clinical symptom of coughing was referred to Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Bogor Agricultural University for evaluation. The radiogram showed difus interstitial nodular pattern on the lungs and enlargement of the spleen. Abdominal ultrasonography and echocardiography was performed to further diagnose the dog. Abdominal ultrasonography was taken using linear probe with frequency 5-11 MHz. Echocardiography was perfomed with right parasternal and left apical views using microconvex probe, with frequency 6-8.8 MHz. Abdominal utrasonogram showed that the dog had billiary sludge, mild splenitis, nephrolithiasis, and urolithiasis. Two dimensional Brightness-mode echocardiography showed thickened and prolapsed mitral valve. Two-dimensional M-mode echocardiography showed increasing of left ventricle lumen dimension (LVID) at systole, decreasing of fractional shortening (FS), and enlargement of left atrial. Color Flow Doppler-mode revealed there was mild regurgitation at the mitral valve. These results lead diagnosis to dilated cardiomyopathy and myxomatous mitral valve disease

Pulmonary Hypertension Care Centers: Hope for the Future From a Patient's and Caregiver's Perspectives

In 1987, after three years of being treated aggressively for asthma and then a prolapsed mitral valve, I was finally diagnosed with primary pulmonary hypertension (PPH). I was told I would be lucky if I lived 2 years without having a heart/double lung transplant and that I didn't have much time to get my affairs in order. There were fewer than 200 patients in the United States at the time. There were no treatment centers, support groups, or even an advocacy group like the Pulmonary Hypertension Association (PHA). I struggled with the loneliness of this diagnosis and the lack of information available.

Classification of Prolapsed Mitral Valve versus Healthy Heart from Phonocardiograms by Multifractal Analysis

Phonocardiography has shown a great potential for developing low-cost computer-aided diagnosis systems for cardiovascular monitoring. So far, most of the work reported regarding cardiosignal analysis using multifractals is oriented towards heartbeat dynamics. This paper represents a step towards automatic detection of one of the most common pathological syndromes, so-called mitral valve prolapse (MVP), using phonocardiograms and multifractal analysis. Subtle features characteristic for MVP in phonocardiograms may be difficult to detect. The approach for revealing such features should be locally based rather than globally based. Nevertheless, if their appearances are specific and frequent, they can affect a multifractal spectrum. This has been the case in our experiment with the click syndrome. Totally, 117 pediatric phonocardiographic recordings (PCGs), 8 seconds long each, obtained from 117 patients were used for PMV automatic detection. We propose a two-step algorithm to distinguish PCGs that belong to children with healthy hearts and children with prolapsed mitral valves (PMVs). Obtained results show high accuracy of the method. We achieved 96.91% accuracy on the dataset (97 recordings). Additionally, 90% accuracy is achieved for the evaluation dataset (20 recordings). Content of the datasets is confirmed by the echocardiographic screening.