Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography
Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true...
Ausführliche Beschreibung
Autor*in: |
Salinger, Tim [verfasserIn] |
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Englisch |
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2017 |
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Anmerkung: |
© The Author(s). 2017 |
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Übergeordnetes Werk: |
Enthalten in: BMC cardiovascular disorders - London : BioMed Central, 2001, 17(2017), 1 vom: 22. März |
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Übergeordnetes Werk: |
volume:17 ; year:2017 ; number:1 ; day:22 ; month:03 |
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DOI / URN: |
10.1186/s12872-017-0519-0 |
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SPR027343294 |
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520 | |a Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. | ||
650 | 4 | |a Aortic valve stenosis (AS) |7 (dpeaa)DE-He213 | |
650 | 4 | |a Cardiac amyloidosis |7 (dpeaa)DE-He213 | |
650 | 4 | |a Dobutamine stress echocardiography |7 (dpeaa)DE-He213 | |
650 | 4 | |a Low-gradient AS |7 (dpeaa)DE-He213 | |
650 | 4 | |a Pseudo-severe AS |7 (dpeaa)DE-He213 | |
650 | 4 | |a Case report |7 (dpeaa)DE-He213 | |
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700 | 1 | |a Liu, Dan |4 aut | |
700 | 1 | |a Herrmann, Sebastian |4 aut | |
700 | 1 | |a Lorenz, Kristina |4 aut | |
700 | 1 | |a Ertl, Georg |4 aut | |
700 | 1 | |a Nordbeck, Peter |0 (orcid)0000-0001-5156-3071 |4 aut | |
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10.1186/s12872-017-0519-0 doi (DE-627)SPR027343294 (SPR)s12872-017-0519-0-e DE-627 ger DE-627 rakwb eng Salinger, Tim verfasserin aut Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. Aortic valve stenosis (AS) (dpeaa)DE-He213 Cardiac amyloidosis (dpeaa)DE-He213 Dobutamine stress echocardiography (dpeaa)DE-He213 Low-gradient AS (dpeaa)DE-He213 Pseudo-severe AS (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Hu, Kai aut Liu, Dan aut Herrmann, Sebastian aut Lorenz, Kristina aut Ertl, Georg aut Nordbeck, Peter (orcid)0000-0001-5156-3071 aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 17(2017), 1 vom: 22. März (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:17 year:2017 number:1 day:22 month:03 https://dx.doi.org/10.1186/s12872-017-0519-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2017 1 22 03 |
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10.1186/s12872-017-0519-0 doi (DE-627)SPR027343294 (SPR)s12872-017-0519-0-e DE-627 ger DE-627 rakwb eng Salinger, Tim verfasserin aut Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. Aortic valve stenosis (AS) (dpeaa)DE-He213 Cardiac amyloidosis (dpeaa)DE-He213 Dobutamine stress echocardiography (dpeaa)DE-He213 Low-gradient AS (dpeaa)DE-He213 Pseudo-severe AS (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Hu, Kai aut Liu, Dan aut Herrmann, Sebastian aut Lorenz, Kristina aut Ertl, Georg aut Nordbeck, Peter (orcid)0000-0001-5156-3071 aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 17(2017), 1 vom: 22. März (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:17 year:2017 number:1 day:22 month:03 https://dx.doi.org/10.1186/s12872-017-0519-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2017 1 22 03 |
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10.1186/s12872-017-0519-0 doi (DE-627)SPR027343294 (SPR)s12872-017-0519-0-e DE-627 ger DE-627 rakwb eng Salinger, Tim verfasserin aut Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. Aortic valve stenosis (AS) (dpeaa)DE-He213 Cardiac amyloidosis (dpeaa)DE-He213 Dobutamine stress echocardiography (dpeaa)DE-He213 Low-gradient AS (dpeaa)DE-He213 Pseudo-severe AS (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Hu, Kai aut Liu, Dan aut Herrmann, Sebastian aut Lorenz, Kristina aut Ertl, Georg aut Nordbeck, Peter (orcid)0000-0001-5156-3071 aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 17(2017), 1 vom: 22. März (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:17 year:2017 number:1 day:22 month:03 https://dx.doi.org/10.1186/s12872-017-0519-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2017 1 22 03 |
allfieldsGer |
10.1186/s12872-017-0519-0 doi (DE-627)SPR027343294 (SPR)s12872-017-0519-0-e DE-627 ger DE-627 rakwb eng Salinger, Tim verfasserin aut Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. Aortic valve stenosis (AS) (dpeaa)DE-He213 Cardiac amyloidosis (dpeaa)DE-He213 Dobutamine stress echocardiography (dpeaa)DE-He213 Low-gradient AS (dpeaa)DE-He213 Pseudo-severe AS (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Hu, Kai aut Liu, Dan aut Herrmann, Sebastian aut Lorenz, Kristina aut Ertl, Georg aut Nordbeck, Peter (orcid)0000-0001-5156-3071 aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 17(2017), 1 vom: 22. März (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:17 year:2017 number:1 day:22 month:03 https://dx.doi.org/10.1186/s12872-017-0519-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2017 1 22 03 |
allfieldsSound |
10.1186/s12872-017-0519-0 doi (DE-627)SPR027343294 (SPR)s12872-017-0519-0-e DE-627 ger DE-627 rakwb eng Salinger, Tim verfasserin aut Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. Aortic valve stenosis (AS) (dpeaa)DE-He213 Cardiac amyloidosis (dpeaa)DE-He213 Dobutamine stress echocardiography (dpeaa)DE-He213 Low-gradient AS (dpeaa)DE-He213 Pseudo-severe AS (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Hu, Kai aut Liu, Dan aut Herrmann, Sebastian aut Lorenz, Kristina aut Ertl, Georg aut Nordbeck, Peter (orcid)0000-0001-5156-3071 aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 17(2017), 1 vom: 22. März (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:17 year:2017 number:1 day:22 month:03 https://dx.doi.org/10.1186/s12872-017-0519-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2017 1 22 03 |
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Salinger, Tim misc Aortic valve stenosis (AS) misc Cardiac amyloidosis misc Dobutamine stress echocardiography misc Low-gradient AS misc Pseudo-severe AS misc Case report Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography |
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Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography Aortic valve stenosis (AS) (dpeaa)DE-He213 Cardiac amyloidosis (dpeaa)DE-He213 Dobutamine stress echocardiography (dpeaa)DE-He213 Low-gradient AS (dpeaa)DE-He213 Pseudo-severe AS (dpeaa)DE-He213 Case report (dpeaa)DE-He213 |
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cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography |
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Cardiac amyloidosis mimicking severe aortic valve stenosis – a case report demonstrating diagnostic pitfalls and role of dobutamine stress echocardiography |
abstract |
Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. © The Author(s). 2017 |
abstractGer |
Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. © The Author(s). 2017 |
abstract_unstemmed |
Background Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery. Case presentation In this article we present a case report of a male patient with pseudo-severe aortic valve stenosis due to cardiac amyloidosis highlighting the diagnostic schedule. The patient underwent stress echocardiography because of discrepant findings in transthoracic echocardiography and cardiac catheterization regarding the severity of aortic valve stenosis. After evaluation of the results, it became clear that he had a need for optimum heart failure medication and implantation of a cardiac resynchronization therapy defibrillator. Conclusion Due to the pitfalls in conventional as well as invasive diagnostics at rest, Stress echocardiography should be considered part of the standard optimum diagnostic spectrum in all unclear or borderline cases in order to confirm the correct diagnosis and constitute optimal therapy. © The Author(s). 2017 |
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score |
7.3994293 |