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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cardiac infections after operations are infrequent but, when present, are often fatal. The 14 autopsied patients in whom purulent pericarditis developed after thoracic operations over an 88 year period at The Johns Hopkins Hospital were studied. Purulent pericarditis developed after cardiac operations in 10 and after pulmonary resections in 4. In 12 of the 14 cases the pericardial sac had been opened. Associated postoperative infection, present in 13 patients, included mediastinitis in 7 and empyema in 3. Staphylococcus was the infection organism in half of the patients. Associated cardiac infection, including endocarditis, myocardial abscess, and graft infection, was present in 5 (36 per cent) patients. Death occurred within 2 months of operation in 11 (79 per cent) patients; it was due to infection in 9, cardiac tamponade in 4, and arrhythmias and heart failure in one. The diagnosis of purulent pericarditis was made before death in only 5 (36 per cent) cases, in part owing to masking of the usual signs of pericarditis in the postoperative patient. Since the introduction of antibiotics, the over-all incidence of purulent pericarditis has decreased. However, pericardial infection after thoracotomy has increased tenfold, and patients undergoing cardiac operations in particular provide a new and increasing population at risk for this disease.
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PMID:A clinicopathological study of post-thoracotomy purulent pericarditis. A continuing problem of diagnosis and therapy. 83 29

A young woman with unexplained radiographic calcification of the ascending aorta was found at necropsy to have healed idiopathic aorititis. Calcification also involved the aortic valve which was stenosed and the mitral valve. Death was the result of infective endocarditis of these valves with aortic ring abscess, rupture of aortic root, and cardiac tamponade.
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PMID:Idiopathic aortitis with calcification of ascending aorta, and aortic and mitral valves. 127 92

Following a case of cardiac tamponade in a patient with the acquired immunodeficiency syndrome (AIDS), we examined the frequency and clinical spectrum of pericardial effusions associated with human immunodeficiency virus infection (HIV) at our institution. Of 187 hospitalized patients documented to have pericardial effusions over a one-year period, 14 (7 percent) were known to be HIV-positive at the time of their echocardiograms. One patient presented with a large effusion and cardiac tamponade, three had moderate effusions, and ten had small effusions. The probable effusion etiology was established in four cases and included endocarditis (2), lymphoma (1), and myocardial infarction (1). In hospital mortality was 29 percent (4 of 14). From our study, as well as a growing number of reports in the literature, we conclude that HIV-associated pericardial effusions are frequently seen and that their clinical spectrum is broad.
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PMID:HIV-associated pericardial effusions. 151 33

We evaluated 77 patients with symptomatic mitral stenosis for balloon valvuloplasty. Five patients were excluded from the procedure due to the presence of intra-atrial thrombi or mitral valve endocarditis as detected by 2D echocardiography. The mean age of the 72 treated patients was 38 +/- 11 years, 68 were NYHA functional class II or IV: only 6 patients had valvular calcification. Three patients had severe liver failure, 2 were chronic alcoholics, one had liver cirrhosis, 2 had severe weight loss and 13 had pulmonary hypertension at systemic levels. 69 patients had a technically adequate procedure, one patient died, 1 developed cardiac tamponade and 1 failed. Mitral valve area increased from 0.93 +/- 0.34 to 2.38 +/- 0.67 cm2. Mitral incompetence increased in only 16 patients. After a mean follow up period of 15 +/- 5 months (range 8 to 27), 56 patients remained in FC I or II. Mitral valve area remained satisfactory in 54 patients. Mitral valve anatomy evaluated by echocardiography is helpful to predict immediate and late outcome. We conclude that balloon mitral valvuloplasty is the first choice for patients with severe symptomatic mitral stenosis.
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PMID:[Percutaneous mitral valvuloplasty as a treatment of choice for mitral stenosis. Immediate results and long-term follow-up]. 184 2

Cardiac involvement is being identified more often clinically and at autopsy in patients with AIDS. Recent estimates suggest that in the United States as many as 5000 patients per year may have cardiac complications resulting from HIV infection. Patients with AIDS may have pericardial, myocardial, and/or endocardial disease. Pericardial tamponade and/or constriction may be related to neoplasms, infections, or nonspecific effusions. Myocardial dysfunction may result from specific neoplastic infiltration or myocarditis. Particularly intriguing is the role of HIV-1 in the nonspecific myocarditis and dilated cardiomyopathy that occurs in patients with AIDS. As in other debilitating conditions patients with AIDS can have nonbacterial thrombotic endocarditis. Infective endocarditis may be a complication, especially in AIDS associated with intravenous drug abuse. Most patients with AIDS have no overt clinical evidence of cardiac disease. When cardiac dysfunction does develop, the signs and symptoms are often misinterpreted to be the result of noncardiac causes (pulmonary failure or infection) which can mimic heart failure. This review is intended to alert the reader to the cardiac manifestations of AIDS, which present a number of diagnostic and therapeutic challenges.
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PMID:Cardiac manifestations of acquired immune deficiency syndrome: a 1991 update. 185 38

Since it is very rare that cardiac tamponade due to myocardial rupture caused by infective endocarditis, occurs we are reporting this case. A 62 year old man, who had underlying diseases of pneumoconiosis and hypertensive heart disease, visited Chikuho Rosai Hospital complaining of chest oppression and general fatigue on Feb. 7, 1987. He was diagnosed as having ischemic heart disease by electrocardiogram. Two days later, he suddenly had chills and a fever, and the laboratory data showed leukocytosis and a positive C-reactive protein (CRP). The echo cardiogram showed mitral regurgitation (MR) and aortic regurgitation (AR), but neither vegetation nor pericardial effusion was observed. On Feb. 16, he was admitted with shock, and he died the next day. The blood cultures grew gram-positive cocci, respectively. From the clinical symptoms, chest roentgenogram and electrocardiogram, we suspected a cardiac tamponade. On autopsy findings, though coronary arteries were intact, the aortic valves had severe valvular adhesions, calcifications and hypertrophies. The rupture hole was observed in the left ventricles, which was just under the aortic valve through the pericardiac space. It seemed that he died of a cardiac tamponade due to the outflow of blood from this hole. On histopathologic findings of the cardiac wall, gram-positive cocci and many of neutrophils were observed.
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PMID:[An autopsied case of infective endocarditis with cardiac tamponade due to myocardial rupture]. 207 73

Echocardiography is commonly performed to assess aortic stenosis, mitral valve prolapse, pericardial effusion and cardiac tamponade, myocardial infarction, endocarditis, and valvular regurgitation. We have found that the more defined and appropriate a request for an echocardiogram is, the better the technician and interpreter can relate observations to the requesting physician. Thus, thorough understanding of the indications and limitations of echocardiography by the primary care physician will result in improved patient care.
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PMID:Echocardiography. Basics for the primary care physician. 218 25

Cardiac abnormalities are frequently reported in patients with acquired immunodeficiency syndrome (AIDS). Much less is known about the true prevalence of cardiac involvement in patients with human immunodeficiency virus (HIV) infection. We prospectively examined 138 consecutive patients with HIV infection including 41 with AIDS, 49 with AIDS-related complex (ARC), 32 with chronic lymphoadenopathy syndrome (LAS) and 16 with asymptomatic HIV infection. Sixty-one patients had opportunistic infection. The prevalence of cardiac involvement progressively increased from patients with HIV infections or LAS (4%) to ARC (14%) to AIDS (37%). "Major" echocardiographic abnormalities (dilated cardiomyopathy and/or infective endocarditis and/or severe pericardial effusion) were identified in 3 patients (2%), "minor" abnormalities (mild pericardial effusion, hypokinesis of the interventricular septum, mild dilatation of the left ventricle in 21 (15%). Electrocardiographic abnormalities unassociated with echo abnormalities or clinical problems were seen in other 11 patients. End diastolic left ventricular dimension (normalized for body surface area) was higher among AIDS respect to pre-AIDS patients (30.1 +/- 7.1 vs 27.6 +/- 7.5; p less than 0.01) and among patients with respect to patients without opportunistic infections (29.5 +/- 6.5 vs 27.5 +/- 2.4; p less than 0.05). Left ventricular shortening fraction was lower in the subgroup with and absolute CD4 lymphocyte count less than 100/mm3 (31 +/- 7 vs 34 +/- 5; p less than 0.055). In conclusion, in a large, unselected group of patients with HIV infection, echocardiogram discloses cardiac abnormalities in 17% of the cases; their clinical relevance is generally low but in selected patients cardiac tamponade and/or dilated cardiomyopathy (secondary to viral myocarditis) may cause death.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiac involvement in HIV infection: a prospective, multicenter clinical and echocardiographic study]. 224 21

Heart disease related to the acquired immunodeficiency syndrome (AIDS) encompasses a number of pathologic findings that may or may not be associated with specific cardiac signs and symptoms. A review of 30 reports revealed that cardiac disorders were apparent in 424 (74%) of 574 AIDS patients. Neoplasms and opportunistic infections each were reported in 46 (8%) patients. The area of the heart most commonly affected was the myocardium. Pericardial disease as a single disorder was apparent in 14 patients, the etiologic bases of which were Mycobacterium tuberculosis. Cryptococcus neoformans infection, and unspecified fibrinous pericarditis. Endocardial disease was histologically evident in 18 patients with nonbacterial thrombotic endocarditis, and one patient was found to have Nocardia asteroides endocarditis. Although cardiac symptoms (dyspnea and chest pains); signs (pulsus paradoxus and murmurs); or ECG, roentgenogram, or echocardiographic manifestations of AIDS may be significant, they are not generally helpful in establishing a clinical diagnosis. Echocardiograms and a heightened degree of clinical suspicion have proven useful in detecting cardiac dysfunction and life-threatening cardiac tamponade.
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PMID:AIDS-related heart disease: a review of the literature. 267 Dec 77

The case of a previously healthy man with endocarditis due to the group C streptococcus, complicated by myocardial abscess and fatal cardiac tamponade, is presented. Group C streptococcus is an unusual cause of endocarditis which tends to produce extensive valve destruction. Early surgery should be considered in patients with endocarditis caused by this organism.
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PMID:Fatal cardiac tamponade in a young man with group C streptococcal endocarditis. 342 84


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