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

5 patients with primary infective endocarditis developed acute cardiac failure because of aortic valve insufficiency. 2 patients were in the active and 3 patients in the inactive stage of infective endocarditis. In 4 patients an aortic and in 1 patient an aortic and mitral valve replacement was performed. The early mortality rate (death within 30 days of operation) was 20 per cent. Once congestive heart failure starts during the course of active endocarditis surgery should be undertaken at an early date.
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PMID:[Aortic valve replacement for acute heart failure due to infective endocarditis (author's transl)]. 108 72

A case of bacterial endocarditis caused by Hemophilus aphrophilus is described, and 22 previously reported cases are reviewed. Eleven patients died and 12 survived; comparison of these two groups reveals that the patients who died were in the older population. The male/female ratio was 3.6:1. The organism was difficult to identify but had a wide range of in vitro bacteriologic sensitivities. This type of endocarditis is frequently associated with emboli and congestive heart failure; each occurred in 9 of 11 fatal cases and 3 of 12 nonfatal cases. Among the nonfatal cases, two patients had both emboli and congestive heart failure, requiring aortic valve replacement despite their precarious clinical condition. Initial drug therapy before results of antibiotic sensitivity tests are known should consist of penicillin combined with streptomycin. When emboli or congestive heart failure appears in Hemophilus aphrophilus endocarditis, early surgical intervention with valve replacement is indicated.
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PMID:Hemophilus aphrophilus endocarditis: review of 23 cases. 110 49

The natural history of the cardiovascular manifestations of systemic lupus erythematosus (SLE) have been altered by corticosteroids which exert their own cardiovascular effects. This study describes clinical and necropsy observations in 36 corticosteroid-treated patients with SLE and compares them to necropsy observations in patients with SLE reported before the use of corticosteroid therapy. The 36 patients averaged 32 years of age, and 33 were women. Systemic hypertension was present in 25 (69 per cent) and left ventricular hypertrophy in 23 (64 per cent) patients. Hypertension was twice as common in the 19 patients who received this drug for more than 12 months (average 38 months) than in the 17 patients who received this drug for less than 12 months (average 6 months), and was almost five times more common among our patients than in patients with SLE in the presteroid era. Congestive cardiac failure occurred in 15 patients (43 per cent), eight times more frequent than that reported in noncorticosteroid-treated patients with SLE. Subepicardial and myocardial fat was increased in all 36 patients. Lupus carditis was similar in frequency but differed morphologically in our patients compared to those not treated with corticosteroids. Libman-Sacks-type endocardial lesions, present in 18 (50 per cent) of our patients, were smaller, fewer in number, univalvular rather than multivalvular, and mainly left-sided. Most verrucae were either partly or completely healed, and some were calcified. Pericarditis, present in 19 (53 per cent) patients, was predominantly of the fibrous type. Myocarditis was present in three patients, each of whom also had endocarditis and pericarditis. The lumen of at least one of the three major coronary arteries was narrowed more than 50 per cent by atherosclerotic plaques in 42 per cent of the 18 patients who received corticosteroids for more than 1 year, but in none of the 17 patients who received corticosteroids for less than 1 year. Four of the eight patients with narrowed coronary arteries had myocardial infarcts. Although vital to the management of SLE, corticosteroids have an over-all deleterious effect on the heart. Systemic hypertension and left ventricular hypertrophy appear or, when present, worsen; congestive cardiac failure increases; epicardial apartment of Me
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PMID:The heart in systemic lupus erythematosus and the changes induced in it by corticosteroid therapy. A study of 36 necropsy patients. 111 70

Methods are described (a) for the estimation of glycogen phosphorylase activity (EC 2.4.1.1) in human blood serum based on the chemical determination of liberated orthophosphate or on the enzymic determination of glucose 1-phosphate in a coupled assay system and (b) for the electrophoretic separation of isophosphorylases I, II, and III in human. Glycogen phosphorylase activities ranging from 1.5 to 18 mU/ml were found in the serum of patients with acute myocardial infarction. In contrast, no glycogen phosphorylase activity was detected in the serum of healthy persons. The enzyme appears in the serum 4 hours after the onset of the infarction and reaches a maximum after 20 to 30 hours. Acrylamide gel electrophoresis of serum after a myocardial infarction revealed only muscle isophosphorylase I, the isoenzyme characteristic of the heart. No phosphorylase activity was detected in serum of patients with angina pectoris, endocarditis, and uncomplicative congestive heart failure. From these findings it appears that the new serum enzyme test may prove to be a valuable addition to presently existing methods for the early differential diagnosis of acute myocardial infarction.
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PMID:The assay of glycogen phosphorylase in human blood serum and its application to the diagnosis of myocardial infarction. 112 38

Sixteen cases of infective endocarditis requiring valve replacement with a prosthesis are described. The indication for surgery was intractable congestive heart failure in all. Fourteen patients underwent aortic valve replacement, with five hospital deaths secondary to cardiac decompensation and one late death related to recurrent periprosthetic insufficiency. Two patients who required mitral valve replacement did well, with no early or late deaths. A collected review of 293 cases of left-sided primary infective endocarditis reported in the English literature confirms the feasibility, advisability, and life-saving potential of urgent surgical intervention in patients with persistent or progressive congestive heart failure, irrespective of the activity of the infective process or the duration of antibiotic therapy. All infected tissue should be resected, and Teflon bolsters should be used to minimize the incidence of periprosthetic leaks. The incidence of prosthetic infection is minimal, contrasted with the fatal potential of procrastination to achieve microbial cure.
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PMID:The case for early surgical treatment of left-sided primary infective endocarditis. A collective review. 116 41

The clinical profile of 28 consecutive patients admitted with infective endocarditis (IE) between 1987 and 1988 was studied. There were 21 males and seven females with a mean age of 24 +/- 11 years. Rheumatic heart disease (RHD) was the commonest underlying disease (68%) followed by congenital heart disease (CHD). Mitral regurgitation with aortic regurgitation were the commonest valvular lesions (47%) in those with RHD while ventricular septal defect was the commonest (43%) in those with CHD. A younger age of onset, complicated course and high mortality were seen in these six patients with acute IE. Persistently positive blood cultures during life or at autopsy were obtained in 21%. Strep viridans was the commonest isolate and was often resistant to streptomycin. 2D echocardicgram revealed vegetations in 96% of patients, the aortic valve (39%) being more commonly affected than the mitral valve (11%). ESR of more than 20 mm drop 1st hour (Wintrobe) was seen in 96%. Thrombophlebitis was a common complication of therapy and cloxacillin the commonest drug implicated. A mortality of 21% as a result of refractory congestive heart failure (CHF) (50%), uncontrolled sepsis (33%) and embolic events (17%) was seen. A rising incidence of culture negative IE, combined aortic and mitral valve disease and CHF is noted.
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PMID:Changing spectrum of clinical and laboratory profile of infective endocarditis. 130 28

Based on our experience and the experience of others, the following classification of patients with mitral valve prolapse has been proposed. Mitral valve prolapse - Anatomic includes patients with a wide spectrum of mitral valve abnormalities from mild to severe. Symptoms, physical findings and laboratory abnormalities in these patients are directly related to mitral valve dysfunction and progressive mitral regurgitation. Complications related to abnormal mitral valve include infective endocarditis, thromboembolic events, cardiac arrhythmias, progressive mitral regurgitation, rupture of chordae tendineae and congestive heart failure. Individuals with thick mitral leaflets and mitral systolic murmur are at higher risk of developing complications. The term mitral valve prolapse syndrome refers to the occurrence of symptoms such as palpitation, chest pain, fatigue, poor exercise tolerance, dyspnea, orthostatic phenomena and syncope or presyncope in patients with mitral valve prolapse which cannot be explained on the basis of mitral valve abnormality alone. The pathogenesis of these symptoms in patients with mitral valve prolapse syndrome appears to be related to metabolic neuroendocrine abnormalities. Preventing infective endocarditis is a major consideration in patients with mitral valve prolapse. Significant mitral regurgitation with the development of congestive heart failure often requires mitral valve surgery. The most important therapeutic approach in patients with mitral valve prolapse syndrome is to explain the mechanisms of symptoms and to reassure the patient.
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PMID:Mitral valve prolapse: etiology, clinical presentation and neuroendocrine function. 134 25

Between 1986 and 1989 there were 9 cases of idiopathic congestive heart failure at this clinic. Normally heifers in the last 1/3 of pregnancy and young cows aged between 2.5 and 3.5 years were affected, but the disease also occurred in one younger (1.5 years), one older (6 years) and in one male animal. In contrast to other reports, myocardial fibrosis in the State of Hesse was only seen in the Rotbunte breed. The animals suffered from a severe heart failure with venous congestion and congestive edema of the brisket, the submandibular area and the ventral abdomen. In most cases there is no precise difference in history, clinical findings and laboratory findings between myocardial fibrosis, traumatic pericarditis and endocarditis valvularis. Only pathological and histological examinations of the heart confirm a suspected myocardial fibrosis: The heart is enlarged and dilatated and seems to be non-elastic. Microscopically a scattered interstitial fibrosis and signs of myocardial degeneration are visible.
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PMID:[Myocardial fibrosis of cattle in Hesse]. 138 92

The epidemiology, clinical features, microbiology and outcome of 30 episodes of nosocomial endocarditis occurring over a 13-year period were reviewed and compared with 148 cases of community-acquired endocarditis. Twenty-eight patients (93%) had been in hospital for > 1 week and 10 patients (33%) for > 1 month when they developed endocarditis. Left-sided infection was most frequent; only 3 cases involved the tricuspid valve. Compared with community-acquired infection, patients tended to be older, had a greater incidence of congestive cardiac failure (p = 0.001) or hypotension (p = 0.0008) at presentation and were more likely to have bacteremia after an invasive procedure (83 vs 31%; p < 0.00001). Intravascular devices were the presumed source of bacteremia in 11 cases (37%); the same organism was isolated from both the blood and the suspected source of infection. Staphylococcus aureus was the most frequent causative organism, accounting for 17 episodes (57%), including 4 (13%) due to methicillin-resistant strains. Nosocomial endocarditis had a significantly higher mortality than did community-acquired infection (40 vs 18%; p = 0.02). Eight patients (27%) needed valve replacement. Proper adherence to protocols for management of intravascular devices and appropriate antimicrobial prophylaxis before procedures may have prevented endocarditis in 15 of 30 patients.
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PMID:A comparison of hospital and community-acquired infective endocarditis. 144 17

During a 3 year period, 1987-1989, we encountered three major complications associated with parenteral nutrition leading to congestive cardiac failure--acute beriberi, right atrial and superior vena caval thrombosis, and fungal endocarditis. Unrecognized, these are invariably fatal. Persistent vomiting from intestinal obstruction led to the development of thiamine deficiency in the patient with beriberi. Recurrent catheter tip sepsis probably accounted for thrombosis and endocarditis in the second and third cases, respectively. These conditions are preventable with careful attention to nutritional replenishment and aseptic technique. In patients with catheter-related sepsis early, repeated blood culture is of diagnostic value. Patients with Staphylococcus aureus catheter-associated bacteraemia require at least 4 weeks of appropriate antibiotic therapy. Recurrent sepsis, especially when associated with pulmonary embolic phenomena, is an indication for echocardiography.
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PMID:Cardiovascular complications of parenteral nutrition. 144 2


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