, Gun Bae Yoo, Min Soo Kim, Dong Soo Lee, Yang Hee Lim, Si Hoon Park, Gil Ja Shin It is known that the morphologic expression or progression of hypertrophy in hyertrophic cardiomyopathy(HCMP) occurs mostly during childhood, when the body growth is considerable, but nearly not occurs in adult life. Apical hypertrophic cardiomyopathy is an uncommon variant of HCMP which is characteristic apical hypertrophy of the left ventricle showing characteristic ace of spade diastolic configuratioin of the left ventriculogram. It has not yet been clarified when the progression or development of hypertrophy occurs in apical HCMP. The possibliity of the morphologic changes in apical HCMP has been poposed in previous study, but not proved yet.
We experienced a case of apical HCMP in 62-year-old female, which evolved during 6 years from mild, diffuse left ventricular hypertrophy to more progressed diffuse hypertrophy associated with marked hypertrophy of the apex of left ventricle showing ventriculopraphic picture of apical HCMP. The present case shows the morphologic change in HCMP with progression of hypertrophy during adult life.
, Eun Mi Nam, Si Hoon Park, Gil Ja Shin, Woo Hyung Lee, Bong Suk Shim We describe an unusual 30-year-old female patient with a history of refractory hypertension and hypokalemia. She was diagnosed as primary aldosteronoism with bilateral adrenal hyperplasia 8 years age and blood pressure has been controlled with spironolactone 200mg/day, nifedipine 40mg/day, Cardura 4mg/day and oral potassium supplement till these days.
Recently refractory high blood pressure was developed and about 5×4×4.5cm sized left a-drenal mass was observed by abdominal CT. The hypertension and hypokalemia was controlled by left adrenalectomy.
, Gil Ja Shin, Si Hoon Park, Woo Hyung Lee Hypothyroidism may accompany pericardial may accompany pericardial effusion occasionally, in the patient who complains of any symptom of hypothyroidism and dose not receive treatment. We have experienced two cases of hypothyroidism presenting with the symptoms of dyspnea and chest tightness. The cuase of dyspnea and chest tightness was pericardial effusion and congestive heart failure. So we report two cases of primary hypothyroidism presenting with pericardial effusion and review the literature.
, Si Hoon Park, Hee Jung Oh Coronary artery-to-left ventricular fistula is an unusual anomaly in adult and consists of a communication between one of coronary arteries and cardiac chambers. Most patients with coronary artery to ventricular fistulae are usually asymptomatic, but some can suffer from anginal pain. which can be caused myocardial ischemia due to coronary steal mechanism. In absence of concomitant atherosclerotic coronary artery disease or left ventricular hypertrophy causing an oxygen demand-supply imbalance, coronary steal appears to be a major importance in pathogenesis of myocardial ischemia in cases with generalized arterial systemic fistulae. We experienced 2 incidently found cases of coronary artery-to-left ventricular fistulae. We report these cases with a review of literature.
, Gilja Shin, Hong-Keun Cho, Si Hoon Park Hyperlipidemia is an important risk factor of coronary atherosclerosis. Serum lipids, especially cholesterol level is closely related to coronary artery and early identification and treatment of hypercholesterolemia reduced the risk of ischemic heart disease. In secondary prevention studies, lipid regulation has been demonstrated to result in a reduced incidence of myocardial infarction and mortality. But during the acute phase of a myocardial infarction, the serum lipid pattern is known to be rapidly changed and consequently dose not reflect the baseline level of the patient. Total serum cholesterol concentrations measured within 24 hours after acute myocardial infarction are likely to reflect basal levels, thus they must be used as the reference for the diagnosis and treatment of hyperlipidemia. If serum lipid levels were not measured within 24 hours of acute chest pain, it is essential to correct the lipid level to the baseline level. So we investigated the following. First, serum lipid alteration during the acute phase of acute myocardial infarction, second, the factors that are related to lipid change, third, the time to check the baseline value of lipid level during the acute phase of myocardial infarction.
We have measured the total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride at admission time and the next day in a group of 51 acute myocardial infarction patients who had acute chest pain.
First, total cholesterol, LDL cholesterol at the next day were significantly reduced. Second, positive correlation was noted between lipid alteration and the lipid level that was checked at admission time. Last, male groups had more significant reduction of LDL cholesterol than female groups.
Cholesterol levels thats were checked the next day were significantly reduced in comparison with the cholesterol value registered at hopital admission. Consequently, it is essential to check the lipid level at the time of hospital admission. But if it was not done, corrected values are a useful guide to patients basal lipid state and treatment references.
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