Page 34 - Clinical Pearls in Cardiology

22 Clinical Pearls in Cardiology

A unilateral earlobe crease was found to be associated
with an intermediate degree of risk of coronary artery
obstruction.
33. Which cardiac conditions are associated with
exophthalmos?
Two cardiac conditions associated with exophthalmos
are thyrotoxic heart disease and advanced congestive
heart failure with high venous pressure. In congestive
heart failure, the stare is probably due to lid retraction
caused by the strong sympathetic tone accompanying
the very low cardiac output. This eye protrusion may
be exaggerated by the slight proptosis caused by high
venous pressure.
34. What is the importance of blue sclera in cardiovascular
examination?
There are three syndromes which are associated with
blue sclera and all of them have coexisting significant
cardiac defects. These syndromes are the following:
• Osteogenesis imperfecta: associated with aortic
regurgitation
• The Marfan’s syndrome: associated with aneurysms
of large blood vessels and mitral or aortic regurgitation
• The Ehlers-Danlos syndrome: associated with atrial
septal defect, tetralogy of Fallot and regurgitant
valvular lesions.
35. Describe the characteristic morphological features of
Down’s syndrome and what are the associated cardiac
abnormalities?
Down syndrome is the most common chromosome
abnormality among live born infants. It is the most
frequent form of intellectual disability, and is caused by a
microscopically demonstrable chromosomal aberration