Internal Medicine

0521779407-C01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:53

310 Chordae Tendineae Rupture Chromium Deficiency

➣Normal left ventricular (LV) systolic function and dimensions

➣Normal left atrial dimensions

■Cardiac Catheterization

➣Prominent V wave in pulmonary capillary wedge pressure

➣LV and left atrial (or pulmonary capillary wedge) pressures equal

in late systole

➣Low cardiac output and index

➣Detect and quantitate mitral regurgitation during left ventricu-

lography

➣Normal LV function and no segemental wall motion abnormali-

ties

differential diagnosis

■Aortic stenosis

management

■see section under Papillary Muscle Dysfunction and Rupture

■Medical and surgical treatment for acute MR due to chordae tendinae

■rupture similar to papillary muscle rupture

specific therapy

n/a

follow-up

n/a

complications and prognosis

n/a

Chromium Deficiency.................................

ELISABETH RYZEN, MD

h&p

Abnormal glucose tolerance in chromium-deplete animals, but no

clear relevance of animals studies to humans, no evidence chromium

needed for insulin action. Glucose intolerance and peripheral neuropa-

thy rarely occur in patients receiving long-term TPN.

Tests/DDx/Mgt/Specific Therapy/FU/Complications & Prognosis:

N/A