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Doppler Echocardiography Diagnosis of Right Ventricular Outflow Tract Obstruction

Arch Intern Med. 1990;150(10):2212. doi:10.1001/archinte.1990.00390210156039.
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(Continued from p 2209.)

To the Editor.—We agree with Israeli et al1 that two-dimensional echocardiography allows us to detect anterior mediastinal masses, to differentiate between intracardiac or extracardiac origin and to assess the cardiovascular structure distortion. Doppler echocardiography enables us to value the degree and severity of right ventricular outflow tract obstruction and pulmonic stenosis by extrinsic compression. We describe two cases to illustrate other advantages of this technique.

Report of Cases.CASE 1.—Seven years ago, a 27-year-old man with an anterior mediastinal mass died during general anesthesia while a biopsy specimen of the mass was being obtained. A lymphoblastic lymphoma, provoking right ventricular outflow tract obstruction and pulmonic stenosis was found at autopsy. The cause of death was increased compression of these cardiovascular structures due to general anesthesia.

CASE 2.—A 20-year-old man sought medical attention because of a 2-week history of cough, shortness of breath, and orthopnea.


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