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

A 43-year-old patient with preexisting mitral valve prolapse and Cardiobacterium hominis endocarditis with partial destruction of the posterior mitral valve leaflet is described. Successful treatment was achieved with partial resection of the posterior mitral valve leaflet and antibiotic therapy. Because of a hypersensitivity reaction, initial therapy with penicillin G and gentamicin was stopped and substituted with cefazolin. No relapse of endocarditis was observed after 12 months of follow-up. Using micro broth dilution technique the isolated strain was shown to be most susceptible to penicillin G, cephalothin, and ciprofloxacin, with minimal inhibitory concentrations of 0.00025, 0.004, and 0.002 mg/l, respectively; and with minimal bactericidal concentrations (99.9% killing) of 0.25, 0.12, and 0.008 mg/l, respectively. We conclude that cephalosporins of the first generation or ciprofloxacin may be good alternatives to penicillin G in the treatment of C. hominis infection in patients known to be hypersensitive to penicillin.
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PMID:Cardiobacterium hominis endocarditis in a patient with a hypersensitivity reaction to penicillin. Successful treatment with partial resection of the posterior mitral valve leaflet and antibiotic therapy with cefazolin. 227 22

A case of WPW syndrome combined with mitral regurgitation caused by infective endocarditis underwent surgical division of accessory pathway and mitral valve replacement preserving posterior leaflet simultaneously. A 56-years old woman suffered atrial fibrillation with pseudo VT and cardiac failure caused by mitral regurgitation. Electro-physiological study (EPS) revealed accessory pathway in postero-lateral wall in left atrium and atrio-fascicular pathway like James bundle in AV node. ECHO cardiography showed mitral valve prolapse and severe regurgitation. Accessory pathway was divided surgically and deep freeze coagulation was followed. Perforation of anterior leaflet and chordal rupture of posterior leaflet caused by infective endocarditis were repaired by annuloplasty (Kay and McGoon method) at first, but regurgitation retained moderately. After re-clamping of aorta, mitral valve was replaced with prosthesis (SJM 29 mm) preserving posterior leaflet. Postoperative examination revealed division of accessory pathway and no regurgitation of mitral prosthesis.
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PMID:[Simultaneous operation of WPW syndrome combined with mitral regurgitation caused by infective endocarditis]. 234 36

The major causes of systemic embolism from valvular heart disease (mitral, aortic and mitral valve prolapse), prosthetic valves (both mechanical and tissue valves) and infected valves (endocarditis) are reviewed from the standpoint of their incidence and complications. Recommendations for therapy with anticoagulants or other antithrombotic therapy are set forth following the guidelines recently provided by the Second American College of Chest Physicians Conference on Antithrombotic Therapy. Adherence to these recommendations can significantly decrease the risk of systemic embolism in patients with these valvular heart problems.
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PMID:Valvular heart disease, infected valves and prosthetic heart valves. 240 24

A retrospective review of the records of 135 patients with proven or suspected endocarditis, seen between January 1970 and December 1987, is presented. Among the findings: (1) Mitral valve prolapse (MVP) as an underlying lesion was more common in the 1980s group of patients (22%) than in the 1970s group (6%, p less than 0.01); (2) no significant difference was found in the occurrence of pathogens between the 1970s and the 1980s groups of patients; (3) in most patients (17 of 19) with MVP, the organisms isolated were Streptococci viridans; (4) most patients (15 of 17) with MVP had undergone a dental procedure without prior antibiotic treatment in the two months prior to admission. Prophylactic antibiotic treatment is suggested in patients with MVP undergoing dental procedure, especially in a subset of patients with flail or redundant valve leaflet as 16 of our MVP patients (out of 17) had this pathology on echocardiogram.
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PMID:Native valve infective endocarditis in the 1970s versus the 1980s: underlying cardiac lesions and infecting organisms. 240 99

The frequency of mitral valve prolapse was assessed in 48 patients with mitral valve endocarditis and in 96 controls matched for age and sex, attending a routine family screening clinic or having surgery of the limbs. The frequency of mitral valve prolapse in cases with endocarditis (9 of 48 patients) was more than three times that in controls (6 of 96) (odds ratio 3.5; 95% confidence interval [CI] 1.1-10.5). When patients with rheumatic heart disease, an established risk factor for infective endocarditis, were excluded from the study group, patients were nearly six times more likely to have infective endocarditis than were controls (odds radio 5.7; 95% CI 1.8-18.4). However, a higher risk of infective endocarditis was seen only in the subjects with mitral valve prolapse and a previously known systolic murmur (odds ratio 14.5; 95% CI 1.7-125). The results indicate that mitral valve prolapse constitutes a true risk factor for infective endocarditis only when associated with the presence of a precordial systolic murmur.
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PMID:Mitral valve prolapse as a risk factor for infective endocarditis. 257 95

We conducted a population-based study to examine the association between clinical and Doppler echocardiographic characteristics and physicians' recommendation for endocarditis prophylaxis. Of 127 consecutive Olmsted County, Minnesota, residents with newly documented isolated mitral valve prolapse, endocarditis prophylaxis was recommended three to four times more often in patients under 40 years compared with those more than 60 years of age. Using multiple logistic regression, for every 10-year increment in age, there was a 30% independent reduction in recommendations for endocarditis prophylaxis. Doppler evidence of mitral regurgitation was also independently associated with recommendations for endocarditis prophylaxis. Observations from physical examination, including systolic murmur and systolic click, were weakly associated with endocarditis prophylaxis recommendations. Mitral valve appearance (thickened vs not) was not associated with endocarditis prophylaxis. Although current recommendations for endocarditis prophylaxis and mitral valve prolapse do not address age and Doppler-detected mitral regurgitation, these variables are strongly associated with clinical decisions. Prospective, longitudinal, population-based studies are needed to define endocarditis risk further in subgroups with mitral valve prolapse to provide a more scientific basis for clinical decision making.
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PMID:Factors associated with the recommendation for endocarditis prophylaxis in mitral value prolapse. 258 75

Mitral valve prolapse continues to arouse considerable interest because of its worldwide prevalence, lack of unanimity in diagnostic criteria, and association with such potentially serious complications as angina-like chest pain, cardiac arrhythmias, sudden death, progressive mitral regurgitation, cerebral embolism, and infective endocarditis. This review includes a discussion of the prevalence of mitral valve prolapse around the world, a critical review of the diagnostic criteria, and a discussion of the pathophysiology of the important complications, with special emphasis on cardiac arrhythmias.
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PMID:Mitral valve prolapse. 265 47

Cardiogenic embolism has accounted for one in six ischemic strokes in recent clinical studies. We review the recent clinical literature about the natural history, diagnosis, and management of cardioembolic stroke. Long-term anticoagulation may be indicated for primary stroke prevention in high-risk patient subgroups with non-rheumatic atrial fibrillation. The prevalence of left ventricular thrombi, and probably also emboli, following an acute anterior myocardial infarction has been reduced by heparin, but the value of subsequent oral anticoagulation for persistent left ventricular thrombi has been disputed. Two clinical subgroups of mitral valve prolapse have been emerging: one benign and the other prone to complications, including embolism. Paradoxical embolism has increasingly been reported as contrast echocardiography has permitted a reliable diagnosis of patent foramen ovale. The embolic risk of infective endocarditis is low (less than 5%) when infection is controlled; early embolism during uncontrolled infection does not strongly predict later stroke. Low-intensity anticoagulation (international normalized ratio, 2.0 to 3.0) may be sufficient prophylaxis for many embolism-prone cardiac disorders.
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PMID:Cardiogenic brain embolism. The second report of the Cerebral Embolism Task Force. 185 32

Since its original description by Barlow over a quarter of a century ago, mitral valve prolapse has become one of the commonest heart diseases around the world. It is commoner in women than men, in thinner than heavier subjects, and in younger than older persons. A unifying concept of a valvular-ventricular disproportion serves to explain the various conditions in which mitral valve prolapse occurs. The etiology of chest pain which is the most frequent symptom that brings the patient with mitral valve prolapse to a physician is multifactorial. Diagnosis of mitral valve prolapse is based on clinical grounds chiefly by careful auscultation. Echocardiography, angiocardiography, and radionuclide ventriculography are valuable adjuncts. Prognosis in the majority is excellent except when complications occur, such as progressive mitral regurgitation, infective endocarditis, cerebral ischemic episodes, and sudden death. For mitral valve surgery repair is preferred to replacement.
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PMID:Mitral valve prolapse: an overview. 267 3

A 69-year old man with clinically silent mitral valve prolapse developed infective endocarditis secondary to Eikenella corrodens after dental work. The patient required surgical removal of abscessed teeth and long-term antibiotic therapy. E. corrodens is a gram-negative coccobacillus which normally inhabits the oropharynx, gastrointestinal tract, and upper respiratory tract. The organism can cause cutaneous and abdominal abscesses, meningitis, osteomyelitis, and endocarditis. Patients with mitral valve prolapse and a pre-existent systolic murmur or Doppler echocardiographic evidence of mitral regurgitation should receive prophylactic antibiotics for any procedure associated with a bacteremia. An infection caused by E. corrodens should be considered in patients with fever after dental manipulation or in patients with "culture-negative" endocarditis.
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PMID:Eikenella corrodens: an unusual cause of endocarditis in a patient with silent mitral valve prolapse. 269 71


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