eLetters

179 e-Letters

published between 2020 and 2023

  • Platypnoea-orthodeoxia syndrome: is it so rare?
    F Godart
    Dear Editor:

    We read with interest the article by Kubler et al[1] concerning 3 patients with platypnoea-orthodeoxia syndrome. As reported, this syndrome is infrequent and the diagnosis can be difficult. It is characterised by dyspnoea and arterial hypoxaemia induced by upright position that resolved by recumbency. This is usually the consequence of right-to-left shunt at the atrial level. Such shunting is frequent in...

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  • Myocardial perfusion defects visualized by MCE in hypertrophic cardiomyopathy
    Gustavo Camarano
    Dear Editor:

    I read with interest this case report from Hirooka and colleagues.[1] Myocardial contrast echocardiography (MCE) allows the assessment of myocardial perfusion, however, several technical issues remain unresolved and artifacts are quite common.

    It is highly debatable whether the perfusion defect shown represents myocardial ischemia due to systolic compression of the LAD septal branches. If that w...

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  • Atrium is not the only location for ANP
    Serdar Kula

    Dear Editor

    Fruhwald FM and their colleagues mentioned about ANP synthesis from the atrium in their lecture. Most of the ANP is synthesized in the myocites of atrium and the synthesis is prominent in the right atrium than the left. Another location of the ANP synthesis is the ventricles. The highest ANP expression is in the intrauterine period, it declines after birth and reaches to the adult levels of 1-2% of atriu...

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  • Survival of patients with a first hospital admission for heart failure
    Kate MacIntyre

    To the Editor;

    Cowie et al(1) reported high case fatality rates in a population-based cohort of patients with incident heart failure between 1995 and 1996. Survival was 81% at one month, 75% at 3 months, 70% at 6 months, 62% at 12 months and 57% at 18 months. There are few population data that describe the contemporary survival of patients with heart failure.

    The Linked Morbidity Record Database con...

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  • A further case of left ventricular opacification with intracoronary echo contrast during PTSMA
    RAP Skyrme-Jones

    We read the case report by Elliott et al (1) with great interest and would like to add to their findings. In three of five consecutive patients undergoing percutaneous septal ablation (PTSMA) for hypertrophic cardiomyopathy (HCM) they observed left ventricular cavity opacification during selective injection of the first septal perforator with the contrast agent Optison.

    We treated a 61 year old man with a long hist...

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  • A 'Persistent' Problem with Pulmonary Atresia and Intact Ventricular Septum
    Pradeep Vaideeswar

    Dear Editor

    We read with interest the case report by Codispoti et al, depicting an association of pulmonary atresia and intact inter-ventricular septum (PAIS) with persistent pulmonary hypertension of the newborn. In our study of 24 autopsied cases of PAIS, we found four cases (16.7%) with persistence of fetal circulation. All were a few days old with varying degrees of ventricular hypoplasia and tricuspid steno...

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  • Discussion of worldwide perspective of valve disease should include mitral valve prolapse
    Tsung O Cheng
    Dear Editor:

    I enjoyed reading the recent article on the worldwide perspective of valve disease by Soler-Soler and Galve from Barcelona, Spain.[1] But I was surprised that no mention was made of mitral valve prolapse (MVP) anywhere in their article.

    MVP is the commonest valve disorder in the United States as well as in many parts of the world.[2] It also has a prevalence of 4.3% in Spain (see table).

    Prevalence (%...

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  • IV and oral flecainide for the cardioversion of acute AF
    Benjamin Mazouz

    Dear Editor

    I read, with great interest the article by Alp et al comparing intravenous and oral flecainide for the cardioversion of acute atrial fibrillation.[1] However, the article concludes that if a patient converts, there is no difference in the percentage of cardioversion by either route (even though the numbers presented tend to favour the oral route). But it fails to mention if there was any differences...

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  • Diagnostic role of BNP not yet established in heart failure
    Martin J Landray
    Dear Editor

    Cowie's editorial envisages a clinical role for measurement of brain natriuretic peptide (BNP) in the near future.[1] However, while the potential for risk stratification and monitoring of treatment in patients with heart failure is encouraging, we would urge caution regarding the diagnostic utility of plasma BNP concentration.

    There is little doubt that the diagnosis of heart failure is difficult -...

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  • Creatinine kinase rise post partum
    P Rachael James
    Dear Editor

    In the case report by Sutaria et al (Heart 2000;83:97-98) an acute anterior MI complicated the routine administration of ergometrine after a spontaneous vaginal delivery. A peak creatinine kinase (CK) of 9858 U/l was reported (CK-MB fraction 8%) with the apparent implication that this CK rise reflected solely myocardial damage. The myometrium, however, is a source of CK and childbirth results in six fold...

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