Supravalvular aortic stenosis.
نویسندگان
چکیده
A murmur was first heard in 1940 by a school physician when the patient was 8 years old. At the age of 19 the boy complained of easy fatigue. In 1951 a harsh systolie murmur, grade III to IV, was heard at the second right interspace near the sternum; it was accompanied by a thrill over the cervical vessels. A diastolic murmur was not heard. A rather loud second aortic sound was noted. The electrocardiogram displayed an R wave in V2 and V, that was much smaller than in V, (fig. 1). The roentgenogram showed a double aortic impression in the barium-filled esophagus. A ve.nous angiocardiogram excluded gross anomalies of the aortic arch. A diagnosis was made of aortic stenosis, possibly subvalvular. In January 1957 serious anginal discomfort and palpitation after very little exertion appeared. The patient was admitted to our hospital ward on August 29, 1957. On examination we found a debilitated young man (25 years), with some degenerative stigmata, such as long slender fingers and toes, prognathism, and thoracic kyphosis. He was 159 cm. tall and weighed 45.5 Kg. At the second right interspace we heard a grade V harsh systolic murmur, radiating to the carotid arteries, accompanied by a very evident carotid shudder. At the third left interspace a holodiastolic decrescendo murmur was heard. The phonocardiogram showed a diamondshaped systolic murmur, ending just before a second sound of great amplitude. The electrocardiogram showed QS complexes from V2 to V,; in V,
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ورودعنوان ژورنال:
- Circulation
دوره 18 5 شماره
صفحات -
تاریخ انتشار 1958