Chiari Network Endocarditis: Not Just an Innocent Bystander

Mousavi, Negareh; Bhagirath, Kapil M.; Ariyarajah, Vignendra; Fang, Tielan; Ahmadie, Roien; Lytwyn, Matthew; Jassal, Davinder S.; Seifer, Colette

doi:10.1111/j.1540-8175.2008.00651.x

Cited by 20 publications

(13 citation statements)

References 15 publications

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“…It is oft en found as an incidental fi nding on imaging studies, characterised by a whip-like motion within the right atrium (Poanta et al 2010). Th e Chiari network has been reported to be involved in the pathogenesis of thromboembolic disease (Yuen and Dickens 1992), endocarditis (Mousavi et al 2008) and arrhythmias (Clements et al 1982), but the bulk of the literature suggests it is oft en clinically insignifi cant (Loukas et al 2010). Its signifi cance with regard to management of pregnancy is largely unknown.…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of Pfeiffer syndrome prior to 20 weeks’ gestation

Gómez-Gómez

Fernández-Alonso

Moreno-Ortega

et al. 2013

Journal of Obstetrics and Gynaecology

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We describe the antenatal and intrapartum care of a 21-year-old nulliparous patient with a known prominent Chiari network.At 19 years of age, this patient was referred to cardiologists with symptoms of inappropriate tachycardia in response to exercise and intermittent nocturnal breathlessness. ECHO revealed a large mobile fi lamentous structure in the right atrium, prolapsing through the tricuspid valve. A diagnosis of a prominent Chiari network was made. Aft er a normal exercise stress test, she was discharged from the clinic. No further investigations or follow-up were arranged. Th e patient booked with the maternity department at 11 weeks ' gestation. All baseline observations and investigations were normal. Fetal anomaly scan showed no abnormalities and growth was on the 50th centile. However, given the patient ' s diagnosis of Chiari network, consultant-led care was preferred.A cardiology opinion was sought. No concerns were raised by the department and no special recommendations for pregnancy or delivery were made.Th e pregnancy progressed well. Th e patient presented in spontaneous labour at term and laboured to full dilatation, but aft er failure to deliver following 1 hour of pushing, assisted delivery was required. A live female infant was delivered with Ventouse. Apgars were 9 and 10; weight 3,760 g. Observations remained stable throughout delivery.Th e woman made an uneventful postpartum recovery, and was discharged home the next day with her baby.

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Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of Pfeiffer syndrome prior to 20 weeks’ gestation

Gómez-Gómez

Fernández-Alonso

Moreno-Ortega

et al. 2013

Journal of Obstetrics and Gynaecology

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“… 2 , 3 , 4 Chiari network or Eustachian valve as the primary focus of right-sided endocarditis, in the absence of tricuspid valve involvement, is rare. 5 , 6 We present a case of bilateral infective endocarditis due to Staphylococcus aureus in an intravenous drug user with pulmonary and systemic embolization, where the primary right-sided cardiac involvement was a very large vegetation on the Chiari network rather than on the tricuspid valve.…”

Section: Introductionmentioning

confidence: 99%

Chiari Network and Aortic Valve Endocarditis with Concurrent Pulmonary and Systemic Embolization

Rochlani

Klair

Vallurupalli

et al. 2017

CASE

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“…It may be associated with thrombi formation, and part of the strands may be embolized [16,17]. Infective endocarditis has been reported in association with the CN [18,19]. It also may cause abnormal atrial depolarization favoring supraventricular dysrhythmia [20].…”

Section: Discussionmentioning

confidence: 99%

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2017

J Clin Anal Med

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Özet Amaç: Bu çalışma ile pediyatrik kardiyoloji polikliniğine müracaat eden çocuklardaki Chiari Ağı'nın (CA) transtorasik ekokardiyografi ile prevalansını değerlendirmesi ve diğer kardiyak anomalilerle birlikteliğinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Hastanemizin çocuk kardiyoloji bölümünde Nisan 2013-Nisan 2014 yılları arasında kardiyak muayene ve transtorasik ekokardiyografi uygulanan 2232 çocuk çalışmaya alındı. Rutin M-mode, 2-D ve Doppler uygulandı. Tüm eşlik eden lezyonlar kaydedildi. Erken ve geç diyastolik akım hızı zirve yüksekliklerinin (E/A) 1'in altında olması muhtemel sağ ve sol ventriküler diyastolik disfonksiyonu düşündürdü. Bulgular: 2232 çocuktan 76'sında CA tespit edildi (%3.4) ve en sık ilk bir ayda saptandı. CA ile birlikte en sık görülen anomaliler atrial septal defect (ASD) ve patent foramen ovale (PFO) idi (%55.3). 10 hastada (%13.2) periferik pulmoner stenoz (PPS) ve 7 hastada (%9.21) atriyal septal anevrizma (ASA) tespit edildi. 2232 hastanın 267'sinde (%8.4) ASA saptanırken CA'lı hastalarda ASA sadece 7 kişide (%9.6) saptandı. Tartışma: CA sık görülmeyen, tesadüfi olarak tespit edilebilen ve doğru bir şekilde tanısı konması gereken, her zaman masum olmayan bir defekttir. Bu her zaman normal bir varyant olmayabilir. İlerde olabilecek muhtemel komplikasyonlar nedeniyle Chiari ağı uygun bir şekilde dökümente edilmelidir. AbstractAim: The study was performed to assess the prevalence of Chiari's Network (CN) in a pediatric outpatient department population by using transthoracic echocardiography (TTE) and to determine its association with other cardiac anomalies. Material and Method: 2232 children who underwent cardiac examination and TTE at the pediatric cardiology outpatient department of our institution between April 2013 and April 2014 were included in the study. Routine M-mode, 2-D, and Doppler studies were applied. All co-existent lesions were recorded. Ratio between heights of early and late diastolic flow velocity peaks (E/A) were <1 in tricuspid and mitral valves considered as possible right and left diastolic dysfunctions respectively .(Bu cümle eklendi.) Results: Of 2232 children, CN was detected in 76 patients (3.41%) and found most frequently during the first month. Atrial septal defect and patent foramen ovale (ASD/PFO) was the most common congenital defect seen with CN (55.3%). Ten children (13.2%) had peripheral pulmonary stenosis (PPS) and seven (9.21%) showed atrial septal aneurism (ASA) associated with CN. Of patients with CN, a total of 11 patients (14.5%), 10 of them 1-8 days old and 1 of them 17 days old, had E/A<1 in tricuspid valve. Three (3.9%) patients 1-12 days old demonstrated E/A<1 in tricuspid and mitral valves. Twenty-nine of the studied patients (11%) demonstrated E/A<1 in tricuspid valve (90% 1-30 days old). Of the total 2232 patients, 267 individuals (8.4%) showed ASA whereas there were only 7 cases (9.6%) of CN patients. Discussion: CN is an uncommon and incidental finding that should be recognized appropriately. This may not be always a normal v...

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Chiari Network Endocarditis: Not Just an Innocent Bystander

Cited by 20 publications

References 15 publications

Prenatal diagnosis of Pfeiffer syndrome prior to 20 weeks’ gestation

Prenatal diagnosis of Pfeiffer syndrome prior to 20 weeks’ gestation

Chiari Network and Aortic Valve Endocarditis with Concurrent Pulmonary and Systemic Embolization

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