@entity1377 muscle, a complication of XXXX : clinical presentation, diagnosis, and treatment.

@entity1 @entity1377 @entity339 @entity3126 @entity301 @entity951 @entity1188 @entity397 @entity158 @entity741 @entity583 @entity121
@entity1377 muscle due to @entity583 was encountered in 14 @entity1 during the period 1975-1983. Five of the 14 @entity1 had a history of @entity951 and two had a history of prior @entity583 . Eleven @entity1 with @entity583 developed @entity158 due to @entity741 and/or a murmur of @entity339 and @entity3126 within a week, 3 others had a prolonged course with intermittent @entity158 due to @entity741 and breathlessness for longer periods and then deteriorated. Thirteen of our 14 @entity1 developed a murmur and all but one had @entity3126 on the chest x-ray. Five @entity1 had @entity1188 patterns on the electrocardiogram, the remainder of the @entity1 had only ST- and T-wave changes. Echocardiograms showed fine flutter and notching of the anterior mitral leaflets and vigorous contractions of the left ventricle. Only one @entity1 was demonstrated to have a papillary muscle tip prolapsing into the left atrium on two-dimensional echocardiography. Twelve @entity1 underwent surgery and 8 survived. Seven @entity1 had single-vessel @entity301 , 4 involving the circumflex system and 3 involving the right coronary system. Four of the 7 @entity1 with single-vessel @entity301 survived surgery. Five @entity1 went to surgery with the intra-aortic balloon pump in place and only 3 survived. Three others had the pump inserted intraoperatively and 2 of these survived. Six of 9 @entity1 who had mitral valve replacement and coronary bypass survived. Ejection fraction ranged from 40 to 79%. Surgical survival did seem to be related to the extent of @entity121 , with the best results occurring in the group with a small portion of the @entity397 . Seven @entity1 had a stormy clinical course and required surgery within 10 days of @entity397 . Four of these 7 survived. It seems reasonable to believe that these @entity1 who often have small @entity1188 and limited @entity301 have good potential for survival. Our approach has been to move toward surgery once the diagnosis is made to avoid the sudden deterioration that frequently occurs. The surgical mortality in this group remains in the 30 to 40% range.
