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Search Patient Charts: Hypertrophic

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Search Results for => Hypertrophic <= Result Items 1 - 20

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Case ID: 14220 Sample Image Click to View	:: - TF Case :: - Thumbnails :: No Topic ::


	Diagnosis	Hypertrophic pulmonary osteoarthropathy (HPO)
	History	This 65 y.o. man, with lung cancer (neuroendocrine carcinoma with small cell component) is on concurrent radiation and chemotherapy.
	Findings	A 99mTechnetium methylene diphosphonate bone scan demonstrates bilateral upper and lower extremity periosteal accumulation of bone tracer.
	Differential Dx	Metastatic vs. metabolic bone disease (e.g. Paget’s disease, thyroid acropachy, acromegaly, fibrous dysplasia).
	Discussion	... (continues ...)
	User Group
	Contributor	Milton D Gross :: Veterans Health Administration (VHA) -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 13680 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Apical Hypertrophic cardiomyopathy, episodes of ventricular tachycardia.
	History	A 59 year old female patient presents for evaluation of ongoing chest pain and shortness of breath with exertion. The patient states that she had onset of nausea, diaphoresis and extreme fatigue while doing some general household tasks. She describes her discomfort as left shoulder pain that radiates across to the left side of her chest. She mentions that since this episode she has had daily chest pain, particularly with exertion or emotional stress. She has never had any issues with syncope or near syncope. She has never smoked and denies exposure to secondary tobacco smoke. She denies any alcohol or recreational drug use. Past Medical History: Acute Respiratory Distress Syndrome with bilateral pneumonia three years ago. The patient has never had pulmonary function studies. Family History: The patient has no family history of early onset coronary artery disease, but she does have a history in the family of arrhythmia. Her mother has atrial fibrillation. She has a sister and a brother, both of whom have atrial fibrillation. She denies any family history of sudden unexplained death or fatal arrhythmia. She has two children, ages 37 and 30, the oldest does have a history of "heart palpitations," which has been diagnosed as benign PVCs. An Echocardiogram study showed the patient has marked left ventricular hypertrophy, but no evidence of obstruction. She does have some mild to moderate aortic insufficiency. Her ejection fraction is normal. An EKG study showed the patient has sinus rhythm 60 beats per minute with a short PR, interval of 110 milliseconds. EKG also demonstrates left ventricular hypertrophy with repolarization abnormality. Flipped T-waves are noted throughout. The patient is sent for a cardiac MRI evaluation.
	Findings	» Apical Hypertrophic cardiomyopathy with maximum wall thickness of 2 cm. There is mid cavity obstruction and a possible small apical aneurysm. The maximum wall thickness at basal LV is 1.4 cm involving inferoseptum. The maximum mid LV wall thickness is 1.8 cm at inferoseptum and maximum apical wall thickness is 2 cm at apical septum. » No evidence of LV outflow tract obstruction. There is no mitral valve systolic anterior motion. » No myocardial infarction or fibrosis as indicated by late gadolinium enhancement.
	Differential Dx	• Physiological Left Ventricular Hypertrophy (Athlete’s Heart) • Pathophysiological Hypertrophy due to aortic stenosis or hypertension • Infiltrative heart muscle disease or storage disorder such as Fabry’s Disease
	Discussion	... (continues ...)
	User Group
	Contributor	Eric Jones :: University of Kentucky -
	Reviewer	Michael A Winkler :: University of Kentucky - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 13631 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Cardiomyopathy
	History	17-year-old white male patient presented with right upper quadrant abdominal pain radiating to his back. He also reported a several day history of chest discomfort, body aches and generalized malaise. He complained of chest discomfort, The patient had a strong family history of coronary artery disease. He had been diagnosed with hypertension at the age of 16.
	Findings	ECHO: Summary: 1. Hypertrophic cardiomyopathy: normal LVED with severe LVH, septum worse than posterior wall. No LV outflow obstruction at this time. Normal LV systolic function. 2. Prominent LV apical and posterior wall trabeculations. 3. Apparent tiny apical muscular ventricular septal defect with left to right shunting versus flow within RV apical trabeculations. 4. Trivial mitral regurgitation. 5. Poor subcostal acoustic windows. Cannot exclude a small atrial level shunt. 6. Trivial tricuspid regurgitation. 7. Normal right ventricular size and systolic function. 8. Widely patent aortic arch with no evidence of obstruction. 9. No pericardial effusion. MRI: Assymetrical left ventricular hypertrophy is present, preferentially involving the mid interventricular septum with a lesser degree of hypertrophy of the anterior wall and inferior wall. The maximal septal thickness measures 2.6 cm. The inferior lateral wall in comparison measures 7 mm. Absolute myocardial mass is 301 grams. Indexed mass is 151 gm/m2 (Z score = 10.8) The left ventricle is mildly dilated (6.4 cm). The hypertrophied myocardial segments are hypocontractile. No left ventricular outflow tract obstruction. Normal left and right atrial size. The right ventricle has preserved contractility and function with no hypertrophy. Normal appearances of the pericardium without thickening or effusion. There is normal mitral valve motion with no significant stenosis or regurgitation. There is patchy myocardial delayed enhancement in the septum and anterior wall of the hypertrophied segments, likely indicating fibrosis in these areas.
	Differential Dx	Physiological Left Ventricular Hypertrophy (Athlete’s Heart) Pathophysiological Hypertrophy due to aortic stenosis or hypertension Infiltrative heart muscle and storage disorders such as Fabry’s Disease
	Discussion	... (continues ...)
	User Group
	Contributor	Eric Jones :: University of Kentucky -
	Reviewer	Michael A Winkler :: University of Kentucky - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 12163 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic pyloric stenosis
	History	A 2.5 month old with projectile non-bilious vomitting and lethargy.
	Findings	Ultrasound demonstrates a markedly thickened pylorus that measured 6 mm in width and 32 mm in length. No material was seen to pass through the pylorus during the examination.
	Differential Dx	Hypertrophic pyloric stenosis Normal closed antrum
	Discussion	... (continues ...)
	User Group
	Contributor	Nicholas Lange :: National Capital Consortium -
	Reviewer	William R Carter, M.D. :: National Naval Medical Center Bethesda - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 11914 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric Stenosis
	History	1 month old with projectile vomiting
	Findings	Hypertrophied pyloric muscle is hypoechogenic and the mucosa is echogenic. The length of the pylorus measures 2.2 cm and the thickness measures 3 mm.
	Differential Dx	Hypertrophic pyloric stenosis Pylorospasm / Antral spasm
	Discussion	... (continues ...)
	User Group
	Contributor	Peter Vangeertruyden :: National Capital Consortium -
	Reviewer	Matthew Monson :: Walter Reed Army Medical Center - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 11695 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric Stenosis
	History	6 week old male presents with projectile vomiting, and a history of poor feeding.
	Findings	Sonographic images of the pylorus demonstrate the hypertrophied hypoechoic pyloric muscle, with echogenic mucosa. The length of the pyloric channel is 2.1 cm, and the pylorus is abnormally thickened, measuring 3.2 mm. Additionally, there is a normal SMV/SMA relationship, and the duodenum is noted to cross midline, passing posteriorly to the SMA and is anterior to the aorta.
	Differential Dx	Hypertrophic Pyloric Stenosis
	Discussion	... (continues ...)
	User Group
	Contributor	Paul J. Shogan :: National Capital Consortium -
	Reviewer	Matthew Monson :: Walter Reed Army Medical Center - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 11143 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric stenosis
	History	7 week-old male with projectile vomiting (non-bilious) for the past 24 hours.
	Findings	Ultrasound images of the gastric pylorus demonstrate an abnormally elongated (1.6 cm) and thickened (4 mm) pylorus. Realtime imaging demonstrated peristaltic waves from the proximal stomach which did not transmit through the pylorus.
	Differential Dx	Hypertrophic pyloric stenosis
	Discussion	... (continues ...)
	User Group
	Contributor	Jeremiah R Long :: Walter Reed National Military Medical Center -
	Reviewer	Matthew Monson :: Walter Reed Army Medical Center - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 11110 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric stenosis
	History	21 day old baby boy, with non-bilious projectile vomiting.
	Findings	• Plain Radiograph: distended stomach bubble with little distal gas. • Ultrasound: thickened and elongated pylorus which persisted for and did not relax following feeds. • Fluoroscopy: contrast material did not move past the pylorus of the stomach, despite multiple positional maneuvers over the course of 15 minutes.
	Differential Dx	• Hypertrophic pyloric stenosis • Antral gastric ulcer with scarring • Ectopic pancreas
	Discussion	... (continues ...)
	User Group
	Contributor	Gregory J Hall :: National Naval Medical Center Bethesda -
	Reviewer	Matthew Monson :: Walter Reed Army Medical Center - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 10587 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric stenosis
	History	5 week old male with intermittent and complete non-bilious vomiting.
	Findings	Increased thickness of the pylorus muscle in both longitudinal and transverse planes by Ultrasound.
	Differential Dx	Hypertrophic Pyloric Stenosis Pylorospasm Focal foveolar hyperplasia Eosinophilic gastroenteritis
	Discussion	... (continues ...)
	User Group
	Contributor	Hugh M Dainer :: National Capital Consortium -
	Reviewer	Dawn E Light :: Childrens Hospital of Dayton, OH - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 10484 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric stenosis
	History	7 week old male with progressively worsening vomiting.
	Findings	Ultrasound images of the gastric pylorus demonstrates increased length and muscular thickness.
	Differential Dx	Hypertrophic pyloric stenosis
	Discussion	... (continues ...)
	User Group
	Contributor	Eric D Sturgill :: Naval Medical Center Portsmouth -
	Reviewer	Stephanie A Bernard :: Penn State University - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 10234 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric Stenosis
	History	36 day old female infant with projectile vomiting.
	Findings	The pylorus measures 19.7 mm in length with a wall thickness of 4.8 mm. On cine imaging no gastric contents are observed passing through the pylorus.
	Differential Dx	-Hypertrophic pyloric stenosis --Inadequate distention of the gastric antrum with mistake of the antrum for the pylorus
	Discussion	... (continues ...)
	User Group
	Contributor	Daniel W Gabier :: Naval Medical Center Portsmouth -
	Reviewer	Stephanie A Bernard :: Penn State University - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 10198 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric stenosis
	History	3 week old male with projectile vomiting
	Findings	Sonographic images of the distal stomach revealed increased thickness and length of the pyloric muscle with no passage of gastric contents on real time examination
	Differential Dx	Pyloric stenosis Gastroenteritis Gastro-esophageal reflux Intestinal Malrotation
	Discussion	... (continues ...)
	User Group
	Contributor	Eduardo Escobar :: Walter Reed Army Medical Center -
	Reviewer	William R Carter, M.D. :: National Naval Medical Center Bethesda - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 9674 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric stenosis
	History	One month old male with frequent vomiting and lack of weight gain.
	Findings	The length (17 mm) and muscle width (5 mm) are abnormally large and suggestive of Hypertrophic pyloric stenosis.
	Differential Dx	Differential diagnosis: -Hypertrophic pyloric stenosis -Pyloric spasm
	Discussion	... (continues ...)
	User Group
	Contributor	David Matthew DeLonga :: Naval Medical Center Portsmouth -
	Reviewer	Stephanie A Bernard :: Penn State University - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 9631 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric stenosis
	History	3 week old male with projectile nonbilious vomiting.
	Findings	Long axis sonogram in the region of the gastroduodenal junction shows pyloic length of 18 mm. Transverse image shows muscular pyloric wall of 3.5 mm
	Differential Dx	Hypertrophic Pyloric Stenosis.
	Discussion	... (continues ...)
	User Group
	Contributor	James M McKee :: Naval Medical Center Portsmouth -
	Reviewer	Stephanie A Bernard :: Penn State University - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 9320 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic pyloric stenosis
	History	7 week old female infant with vomiting and lethargy.
	Findings	US imaging of abdomen demonstrated a pyloric channel 18mm in length with the wall of the pylorus measuring 5mm in thickness.
	Differential Dx	Hypertrophic pyloric stenosis.
	Discussion	... (continues ...)
	User Group
	Contributor	Michael E Fenton :: Naval Medical Center Portsmouth -
	Reviewer	Martin N Scott :: Naval Medical Center Portsmouth - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 9034 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric Stenosis
	History	A 4 week old male presented complaining of a one week history of non-bilious vomiting.
	Findings	The pylorus demonstrated abnormal increased wall thickness with a maximum thickness of 3.5 mm in the transverse plane. The length of the pyloric channel was increased and measured approximately 16.7 mm. On real time imaging, very little fluid was seen passing through the pyloric channel.
	Differential Dx	Gastroesophageal reflux Pylorospasm Hiatal Hernia Preampullary duodenal stenosis Malrotation (typically present with bilious vomiting) Duodenal atresia
	Discussion	... (continues ...)
	User Group
	Contributor	Robert A Liotta :: National Capital Consortium -
	Reviewer	Ernesto Torres M.D. :: Civilian Medical Center - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 8718 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic pyloric stenosis.
	History	2 mo old female with over 2 wk history of progressively worsening emesis, now projectile and non-bilious. Patient has recent weight loss.
	Findings	Pyloric muscle hypertrophy > 3mm. Elongated pyloric channel >14 mm.
	Differential Dx	Hypertrophic pyloric stenosis Pylorospasm.
	Discussion	... (continues ...)
	User Group
	Contributor	Karen R Craig :: National Capital Consortium -
	Reviewer	William R Carter, M.D. :: National Naval Medical Center Bethesda - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 8028 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic Pyloric Stenosis
	History	H/O projectile nonbilious emesis, after feeding.
	Findings	Elongated and thickened pylorus (>15-18mm-length, >3.5-4mm-thickness) with associated shouldering of the gastric antrum and compression of the duodenal bulb.
	Differential Dx	-Pylorospasm
	Discussion	... (continues ...)
	User Group
	Contributor	Darryl David Stinson :: Naval Medical Center Portsmouth -
	Reviewer	Maria Flynn :: National Capital Consortium - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 7835 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic osteoarthropathy
	History	61y/o white male with h/o lung cancer with diffuse bone pain and arthralgias.
	Findings	Increased intensity of spine, femora, tibiae, fibulae, radii, ulnae and carpal bones on Tc99m total body bone scan.
	Differential Dx	Metastatic disease Multiple pathologic fractures Paget's Disease
	Discussion	... (continues ...)
	User Group
	Contributor	Julie A Krumreich :: Naval Medical Center Portsmouth -
	Reviewer	David B Turton :: Naval Medical Center Portsmouth - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

Case ID: 7533 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hypertrophic pyloric stenosis
	History	Three week old female presents with frequent projectile vomiting. Patient's father had history of Hypertrophic pyloric stenosis. Child is parents' firstborn.
	Findings	Pylorus is hypertrophied, measuring 4mm in width and 19mm in length. There was no observed passage of food during the ultrasound examination.
	Differential Dx	Hypertrophic pyloric stenosis Gastroenteritis Malrotation
	Discussion	... (continues ...)
	User Group
	Contributor	James M Grimson :: Naval Medical Center Portsmouth -
	Reviewer	Van Thong Ho :: Naval Medical Center Portsmouth - Case Accepted: 2012-09-25 13:10:10-04 :: Revised: 2012-09-20 10:23:54.811575-04 :: Submitted: 2012-09-20 10:23:54.811575-04

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