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- W2022241903 abstract "A 41-YEAR-OLD, 71-kg, 188-cm man with a long history of hemodialysis-dependent end-stage renal disease resulting from chronic glomerulonephritis presented to the authors' institution with a 6-month history of mild dyspnea on exertion. He was otherwise asymptomatic. The patient had undergone a cadaveric renal transplant 13 years before the current admission, but the transplanted kidney failed and was explanted 3 years later. He also had undergone a subtotal parathyroidectomy for the treatment of secondary hyperparathyroidism caused by renal failure. The patient was treated with hemodialysis 3 times per week through a left-arm fistula, which was well tolerated. He denied a history of syncope, angina pectoris, orthopnea, or peripheral edema. The physical examination was significant for a harsh, grade 4 of 6 holosystolic murmur that was heard best at the left upper sternal border accompanied by a thrill. The remainder of the cardiac and pulmonary physical examination was unremarkable. A chest x-ray revealed a mildly enlarged cardiac shadow, but no evidence of active pulmonary disease was observed. A 12-lead electrocardiogram showed voltage criteria for left ventricular (LV) hypertrophy but was otherwise normal. Transesophageal echocardiography (TEE) revealed the images shown in Fig 1, Fig 2, Fig 3, Fig 4. What is the diagnosis? Fig 2A deep transgastric TEE image of the left ventricle and aortic outflow tract showing marked calcification of the aortic valve leaflets and annulus. View Large Image Figure Viewer Download Hi-res image Fig 3A deep transgastric TEE image of the left ventricle and aortic outflow tract showing moderate aortic insufficiency. (Color version of figure is available online.) View Large Image Figure Viewer Download Hi-res image Fig 4A midesophageal 4-chamber TEE image obtained during maximal mitral valve opening showing marked calcification of the middle scallops of the anterior (A2) and posterior (P2) mitral valve leaflets. View Large Image Figure Viewer Download Hi-res image" @default.
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- W2022241903 date "2009-04-01" @default.
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- W2022241903 title "A Patient With Chronic Hemodialysis-Dependent End-Stage Renal Disease Presenting With Mild Dyspnea on Exertion and a Harsh Systolic Murmur" @default.
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- W2022241903 doi "https://doi.org/10.1053/j.jvca.2007.09.011" @default.
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