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This is my sandbox <ref name="pmid25387321">{{cite journal| author=Jokinen E| title=Obesity and cardiovascular disease. | journal=Minerva Pediatr | year= 2015 | volume= 67 | issue= 1 | pages= 25-32 | pmid=25387321 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25387321  }} </ref>.


Hello <ref name="pmid22874472">{{cite journal| author=Maron BJ, Maron MS| title=Hypertrophic cardiomyopathy. | journal=Lancet | year= 2013 | volume= 381 | issue= 9862 | pages= 242-55 | pmid=22874472 | doi=10.1016/S0140-6736(12)60397-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22874472  }} </ref>.
Hello <ref name="pmid22874472">{{cite journal| author=Maron BJ, Maron MS| title=Hypertrophic cardiomyopathy. | journal=Lancet | year= 2013 | volume= 381 | issue= 9862 | pages= 242-55 | pmid=22874472 | doi=10.1016/S0140-6736(12)60397-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22874472  }} </ref>.

Revision as of 16:58, 26 May 2020

This is my sandbox [1].


Hello [2].



Disease Symptoms Physical examination Cardiac murmur ECG CXR Echocardiography
Aortic valve stenosis
  • Exertional chest pain
  • Dyspnea on exertion
  • Decreased exercise tolerance
  • Exertional syncope/pre-syncope
  • Narrow pulse pressure
  • Normal to anacrotic carotid pulse (parvus et tardus)
  • S1 usually normal
  • A systolic ejection click may be audible afer S1
  • Single S2
  • If severe: paradoxical splitting of S2
  • S4 may be audible
  • Mid-to-late peaking systolic ejection murmur
  • Best heard at right intercostal space
  • Radiates equally to the carotid arteries
  • Decseases with Valsalva maneuver
  • Left ventricular hypertrophy
  • Left ventricular strain pattern
  • Left ventricualar hypertrophy
  • If heart failure is present: pulmonary congestion
  • Aortic valve calcification may be visible
  • Mild AS: Aortic Vmax 2.0-2.9 m/s or mean ΔP <20 mmHg
  • Moderate AS: Aortic Vmax 3.0-3.9 m/s or mean ΔP 20-39 mmHg
  • Severe AS: Aortic Vmax ≥ 4 m/s or mean ΔP ≥40 mmHg; AVA typically ≤ 1.0 cm2 (or AVAi ≤ 0.6 cm2/m2)
  • Very severe AS: Aortic Vmax ≥ 5 m/s or mean ΔP ≥60 mmHg
  • Ejection fraction (EF) may be normal or reduced
Aortic valve sclerosis without stenosis
Supvalvular stenosis
Supravalvular stenosis
Hypertrophic cardiomyopathy




constrictive cardiomyopathy should be differentiated from restrictive cardiomyopathy[3],[4]


Differentiating restrictive cardiomyopathy from Other Diseases
Type of disease History Physical examination Chest X-ray ECG 2D echo Doppler echo CT MRI Catheterization hemodynamics Biopsy
Restrictive cardiomyopathy[3][5][4] Systemic disease (e.g., sarcoidosis, hemochromatosis). Atrial dilatation Low QRS voltages (mainly amyloidosis), conduction disturbances, nonspecific ST abnormalities ± Wall and valvular thickening, sparkling myocardium Decreased variation in mitral and/or tricuspid inflow E velocity, increased hepatic vein inspiratory diastolic flow reversal, presence of mitral and tricuspid regurgitation Normal pericardium Measurement of iron overload, various types of LGE (late gadolinium enhancement) LVEDP – RVEDP ≥ 5 mmHg

RVSP ≥ 55 mmHg

RVEDP/RVSP ≤ 0.33

May reveal underlying cause.
Constrictive pericarditis[6][7][7]
  • Thickened pericardium
  • LVEDP – RVEDP < 5 mmHg
  • RVSP < 55 mmHg
  • RVEDP/RVSP > 0.33
  • Inspiratory decrease in RAP < 5 mmHg
  • Systolic area index > 1.1 (Ref CP in the modern era)
  • Left ventricular height of rapid filling wave > 7 mmHg
  • Normal myocardium
  1. Jokinen E (2015). "Obesity and cardiovascular disease". Minerva Pediatr. 67 (1): 25–32. PMID 25387321.
  2. Maron BJ, Maron MS (2013). "Hypertrophic cardiomyopathy". Lancet. 381 (9862): 242–55. doi:10.1016/S0140-6736(12)60397-3. PMID 22874472.
  3. 3.0 3.1 Rammos A, Meladinis V, Vovas G, Patsouras D (2017). "Restrictive Cardiomyopathies: The Importance of Noninvasive Cardiac Imaging Modalities in Diagnosis and Treatment-A Systematic Review". Radiol Res Pract. 2017: 2874902. doi:10.1155/2017/2874902. PMC 5705874. PMID 29270320.
  4. 4.0 4.1 Hong JA, Kim MS, Cho MS, Choi HI, Kang DH, Lee SE, Lee GY, Jeon ES, Cho JY, Kim KH, Yoo BS, Lee JY, Kim WJ, Kim KH, Chung WJ, Lee JH, Cho MC, Kim JJ (September 2017). "Clinical features of idiopathic restrictive cardiomyopathy: A retrospective multicenter cohort study over 2 decades". Medicine (Baltimore). 96 (36): e7886. doi:10.1097/MD.0000000000007886. PMC 6393124. PMID 28885342.
  5. Mogensen J, Kubo T, Duque M, Uribe W, Shaw A, Murphy R, Gimeno JR, Elliott P, McKenna WJ (January 2003). "Idiopathic restrictive cardiomyopathy is part of the clinical expression of cardiac troponin I mutations". J. Clin. Invest. 111 (2): 209–16. doi:10.1172/JCI16336. PMC 151864. PMID 12531876.
  6. Ramasamy V, Mayosi BM, Sturrock ED, Ntsekhe M (September 2018). "Established and novel pathophysiological mechanisms of pericardial injury and constrictive pericarditis". World J Cardiol. 10 (9): 87–96. doi:10.4330/wjc.v10.i9.87. PMC 6189073. PMID 30344956.
  7. 7.0 7.1 Biçer M, Özdemir B, Kan İ, Yüksel A, Tok M, Şenkaya I (November 2015). "Long-term outcomes of pericardiectomy for constrictive pericarditis". J Cardiothorac Surg. 10: 177. doi:10.1186/s13019-015-0385-8. PMC 4662820. PMID 26613929.