The fairly normal PA pressure in this patient with right heart enlargement does suggest to me that this is more likely to be ARVD. HOWEVER, ASD cannot be...
777
Patrick D. Coon
prcoon@...
Dec 2, 1999 4:16 am
I would agree with your assessment of SVASD. I don't remember hearing anything about PA dilation?!? However, wouldn't a PDA,VSD or CSASD cause left sided...
778
Patrick D. Coon
prcoon@...
Dec 2, 1999 4:16 am
Oops...forgot about Ebstein's!! Also, in regards to my previous comment about VSD and LV/LA enlargement, I'm assuming it would be a small defect. If it was...
779
Joe Kreeger
thschrmng1@...
Dec 2, 1999 4:17 am
Very strange phenomena.... In the realm of CHD, I have found in my 7 years as a pediatric echocardiographer that defects usually run in 3's (or sometimes...
780
RTurner33@...
Dec 2, 1999 1:51 pm
Not as strange as your occurrences, But I had three aortic root dissections within a three month period. Two patients were related (marfan's) with ascending...
781
christina judge
tlcjudge@...
Dec 2, 1999 1:52 pm
Yikes! Where in the world do you live, so I can make sure I do not move there! Are you under a leaking nuclear reactor, or what? Just kidding, that really is...
782
Vincent Sorrell
vsorrell@...
Dec 2, 1999 1:53 pm
Joe, The "phenomenom of 3's" is acient and well-known. It is partially related to the fact that we can only find something when we look for it. As our...
783
Samer Jabbour
sjabbour@...
Dec 2, 1999 3:01 pm
Dear Colleagues, I apologize in advance for cluttering your emails with a message that is not directly related to echocardiography. I recently joined this...
784
Patrick D. Coon
prcoon@...
Dec 3, 1999 1:35 pm
Joe, I, too, work for a large academic referral center (Children's in Philadelphia) and have had the same experience over the years. I cannot comment on HLHS...
785
KHarris747@...
Dec 3, 1999 1:37 pm
I have been a pediatric echo tech for 17 years and the law of threes is a well known phenomenon around here too. We usually groan when some baby is born with...
786
KHarris747@...
Dec 3, 1999 1:37 pm
Dear Ms Judge in Carrolton; I work at Children's Medical Center in Dallas and you indeed live where this happens all the time!!!! We alway see groupings of...
787
Dr. Amy Arouni
aarouni@...
Dec 3, 1999 2:53 pm
Hello--- Regarding the "law of threes"---it doesn't only happen with CHD. I'm a noninvasive adult cardiologist, and we had 3 large atrial myxomas in our echo...
788
Robert Magnani
elwood92@...
Dec 4, 1999 3:03 pm
To All: Yep, happens a lot, especially those wonderful Tech. Diff. studies! I work in a rural setting, at a hospital with 200 beds. We do only adult echoes....
789
Luis and Tessa Go
lutego@...
Dec 4, 1999 3:03 pm
Dear Joe, I was just wondering if the incidence of CHD in your locality is the same with that of the national census for your country. If you're providing care...
790
Luis and Tessa Go
lutego@...
Dec 4, 1999 3:03 pm
Dear Dr Bahr, I think a TEE is worth doing to exclude ASD. PDA usually presents with dilated LV and some degree of pulmonary HTN must be present in PDA ( and...
791
Dr. Amy Arouni
aarouni@...
Dec 6, 1999 3:22 pm
I agree with Dr. Go. You should do a TEE with contrast to rule out a shunt, particularly an ASD. Let us know what you find! Amy J. Arouni, MD The Cardiac...
792
Daniel Shindler
shindler@...
Dec 6, 1999 5:28 pm
I need some information about the quality control and equipment performance checking. In my area there a number of cardiologist who uses Echo- testing for...
793
Joe Kreeger
thschrmng1@...
Dec 7, 1999 3:37 pm
In response to geographical location of the facility which exhibits the phenomena of 3's; Atlanta, GA. Our facility receives patient from the surrouding...
794
Laura Perrotta
perrotta@...
Dec 7, 1999 3:38 pm
Perhaps you'll find it useful to have the ICAEL's published Essentials and Standards as they relate to equipment maintenance: The Essentials and Standards...
795
L. Faber
lfaber@...
Dec 8, 1999 2:14 pm
One word of caution concerning the calculation of PA/RV systolic pressures from TR jets: In case of severe TR there is often no high pressure gradient between...
796
Ricardo Munoz, MD
Munoz@...
Dec 8, 1999 3:59 pm
This patient must have a cath , to estimate PVR , PAP, plus A SHUNT, PA distal anatomy etc . R Munoz Children's H Boston...
797
Eduardo S. Caguioa
vicag@...
Dec 9, 1999 3:17 pm
I agree In evaluating TR jet velocities to get a "feel" for pulmonary systolic pressures, we should also consider the systolic function of the RV and the RA...
798
eyad aljamal
e.aljamal@...
Dec 10, 1999 12:37 pm
Congenital tricuspid valve regurgitation is an uncommon condition which might presents in the adult as RV diltation from chronic volume overload...
799
L. Faber
lfaber@...
Dec 10, 1999 12:38 pm
I agree, with Takayasu's and Churg-Strauss-Syndrome high on the list of dd's in this age group. I remember several similar cases. Greetings, L. Faber...
800
Dr. Valdir A. Moises
Valdir.Moises@...
Dec 10, 1999 3:25 pm
If the TR orifice is too large and RA pressure high, the TR velocity may be low. Valdir A Moises Sao Paulo...
801
Luis and Tessa Go
lutego@...
Dec 12, 1999 6:03 pm
Dear Members, If the TR is severe - isn't that the pressure gradient between the RV and RA is high during systole - otherwise, how can there be regurgitation...
802
Dr. Ashok Kakadekar
kakadekr@...
Dec 12, 1999 11:43 pm
Dear Dr Kreeger, This is quite common in pediatric cardiology. I have seen three hypoplastic left heart syndrome babies in two weeks and 3 transpositions in 10...
803
Chun wang Tan
chuntan@...
Dec 13, 1999 3:57 am
Dear Dr. Go, In patients with severe RV failure and dilatation from whatever cause, the ability to generate a pressure gradient from RV to RA is significantly...
804
Zanbilowicz
zanbil@...
Dec 13, 1999 3:58 am
I have great difficulty in arriving at consistant RV measurements on TTE. The classic PSAX M-mode tends to underestimate what I measure in 2-d on apical 4...
805
Meeraji Rao
meerajirao@...
Dec 13, 1999 1:40 pm
My dear colleagues, Yes we do see this funny phenomenon in clinical medicine. more so in cardiology. I believe it occurs more in high volume centres than the...
