Læknaneminn


Læknaneminn - 01.10.1988, Qupperneq 37

Læknaneminn - 01.10.1988, Qupperneq 37
alltaf á blóðþynningu. Eins og áður hefur komið fram fær alltaf viss hluti sjúklinganna illviðráðanlega hjartaþelsbólgu. Því hafa sumir viljað setja þessa sjúklinga á fyrirbyggjandi sýklalyfjameðferð, en sú meðferð er þó ekki almennt viðurkennd. Ef um alvarlega míturlokuleka með hjartabilun er að ræða þarf oft að setja gerviloku í þessa sjúklinga. Lokaorð. Kölkun í míturlokuhring hjartans er algengur hrömunarsj úkdómur í eldra fólki. Sj úkdómurinn getur einnig sést hjá yngri einstaklingum sem hafa truflun á kalkefnaskiptum eða eru með óeðlilega bandvefs- sarnsetningu. Aðeins hluti einstaklinga með kím hefur einkenni þess. Fylgikvillar og einkenni sjúkdómsins eru hins vegar alvarleg: blóðrek, hjartsláttartruflanir, leiðslurof íhjartaoghjartaþelsbólga. Þessirfylgikvillar eru í mörgum tilfellum lífshættulegir. Því skyldi leita eftir og hafa kím í huga hjá einstaklingum með áðurnefnd einkenni. Með tilkomu tvívíddar— ómskoðunar af hjarta hefur opnast greið leið til greiningar. Með bættum meðferðarmöguleikum s.s. með gangráðsísetningum hefur nákvæm greining á fyrirbærinu meiri tilgang fyrir sjúklinginn. Við þökkum Dr. Þorkeli Guðbrandssyni góðar ábendingar og yfirlestur handrits. Heimildir. 1) Nestigo pf, Depace NL, Morganroth J, Kotler MN, Ross J. Mitral annular calcification : Clinical, pathophysiologi, and echocardiographic review. Am Heart J May 1984; 989- 96. 2) Nair CK, Pagano T. Mitral Annular Calcification: New concepts. Hosp Phys December 1983; 1-21 3) Nair CK, Sudhakaran C, Aronow WS, Thomson W, Woodruff MP, Sketch MH. Clinical characteristics of patients younger than 60 years with mitral anular calcium : Comparison with age- and sex- matched control subjects. Am J Cardiol Decemb. 1984; 1286-7. 4) Labovits AJ, Nelson JG, Windhorst DM, Kennedy HL, William GA. Frequency of mitral valve dys-function frorn mitral anular calcium as detected by doppler echocardiography. Am J Cardiol January 1985; 133-7. 5) Savage DD, Garrison RJ, Gastelli WPetal. Prevalenceof submitral (anular) calcium and its correlates in a general population-based sample ( the framingham study Am J Cardiol May 1983; 1375-8. 6) Roberts WC. Morphologic features of the normal and abnormal mitral valve. AmJCardiol March 1983; 1005-28 7) Forman MB, Virmani R. Robertson RM, Stone WJ, Mitral anular calcification in chronic renal failure. Chest March 1984; 367-71. 8) Depace NL, Rohrer AH, Kotler MN, Bresin JH, Parry WR. Rapidly progressing, massive mitral annular calcification Occurence in patient with chronic renalfailure . Arch Intem Med November 1981; 1663-5 9) Mattlem S, Panidis 1, Morris KN, Mints GS, Morganroth J, Ross J, Victor M. Calcification of the tricuspid anulus diagnosed by two-dimensional echo-cardiography. Am HeartJ May 1984; 986-8. 10) Kronson I, Glassman E. Mitral ring calcification in idiopathic hypertrophic subaortic stenosis. Am J Cardiol July 1978; 60-6. 11) Mellino M, Salcedo EE, Lcver HM, Vasudevan G, Kramer JR. Echographic-quantified severety of mitral anulus calcification: Prognostic correlation to related hemodynamic, valvular, rythm, and cunduction abnormalities. AMHeartJ February 1982; 222-5. 12) Nair CK, Aronow WS, Sketch MH et al. Clinical and echocardiographic characteristics of patient with mitral anular calcification. Am J Cardiol March 1983; 992-5. 13) NairCK, Sketch MH, Desai R, Mohiuddin SM, Runco V. High prevalence of symptomatic bradyarrythmias due to atrio ventricular node-fascicular and sinus node-atrial disease in patients with mitral anularcalcification. Am Heart J February 1982; 226-9 14) Cerebral embolism task force. Cardiogenic brain embolis. Arch Neurol January 1986; 71-84. 15) Furlan AJ, Cracium AR, Salcedo EE, Mellino M. Risk of stroke in patients with mitral annulus calcification. Stroke Sept-Okt. 1984; 801-3 16) WongM, TeiC,ShahPM. Sensitivityandspecificityof two-dimensional echocardiography in detection of valvular calcification. Chest October 1983; 423-7. 17) Osterberger LE, Goldstein S, Khaja F, Lakier JB. Functional mitral stenosis in patients with massive mitral annular calcification. Circulation 1981; 3: 472-6. 18) Mclean J, Felner JM, Whipple R, Morris D, Schlant RC. The echocardiographic association of mitral valve prolapse and mitralanuluscalcification. Clincardiol June 1979,220- 3. LÆKNANEMINN ^988-41. árg. 35
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