A 71-year-old woman presented with shortness of breath and involuntary head shaking. Physical examination showed nodding of the head with each heart beat (Video 1). Her pulse rate and blood pressure were 40 bpm and 125/55 mm Hg, respectively. ECG revealed complete atrioventricular block with a ventricular rate of 40 and atrial rate of 75 (Fig. 1a). Transthoracic echocardiography displayed moder...

BACKGROUND Diagnosing heart failure and left ventricular systolic dysfunction is difficult on clinical grounds alone. We sought to determine the accuracy of a heart failure register in a single primary care practice, and to examine the usefulness of b-type (or brain) natriuretic peptide (BNP) assay for this purpose. METHODS A register validation audit in a single general practice in the UK wa...

Cardiomyopathies are common cardiac disorders that primarily affect cardiac muscle resulting in cardiac dysfunction and heart failure. Transgenic mouse disease models have been developed to investigate the cellular mechanisms underlying heart failure and sudden cardiac death observed in cardiomyopathy cases and to explore the therapeutic outcomes in experimental animals in vivo. Echocardiograph...

Heart failure is appropriately described as an epidemic, with 1-2% of health care expenditure being directed at its management. In England, the National Institute for Health and Care Excellence (NICE) has issued guidance on the best practice for the diagnosis and treatment of acute and chronic heart failure. Echocardiography is key to the diagnosis of the underlying cardiac abnormalities, and a...

In the early 1990s, the idea first arose that plasma concentrations of B type natriuretic peptide (BNP) might help target scarce cardiac investigations towards the most deserving. This mainly referred to the possibility that BNP could detect which patients had heart failure and which did not. This was based on the fact that echocardiography slots were limited, and that heart failure was hard to...

echocardiography plays a fundamental role in the evaluation of patients with an intracardiac mass. the ability to distinguish tissue characteristics, location, attachment, shape, size, and mobility non-invasively, quickly, and without the use of ionizing radiation makes echocardiography the ideal diagnostic modality. with careful attention to mass location and morphology, and appropriate applic...

OBJECTIVES To determine the prevalence of isolated left ventricular noncompaction (IVNC) as a cause of heart failure and heart transplantation. METHODS There were 960 patients seen in the heart failure clinic from 1987 to 2005, with a complete evaluation including echocardiography at our center (study population, 82% men, mean age 52 years). The following data were collected: type of heart di...

DG, Struthers AD. Echocardiography in chronic heart failure in the community. Quart J Med 1993;86:17-23. 3 McMurray J, Hart W, Rhodes G. An evaluation of the economic cost of heart failure to the National Health Service in the United Kingdom. Br J Med Econ 1993;6:99-110. 4 Remes J, Miettinen H, Reunanen A, Pyorala K. Validity of clinical diagnosis of heart failure in primary health care. Eur He...

Acute pulmonary embolism (PE) is a common disease which frequently results in life-threatening right ventricular (RV) failure. High-risk PE, presenting with hypotension, shock, RV dysfunction or right heart thrombus is associated with a high mortality, particularly during the first few hours. Accordingly, it is important to commence effective therapy as soon as possible. In the case described i...