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

Two patients with chronic valvular heart disease and myocardial infarction were assisted at our hospital. Both of them were febrile and only one had petechiae associated with signs of valvular involvement led to suspicion of infective endocarditis. Although blood cultures were negative, echocardiographic, surgical and anatomopathologic findings were compatible with infective endocarditis. They required cardiac surgery during the acute phase of the infection because they presented progressive hemodynamic deterioration and no satisfactory response to antimicrobial regimen too. One patient died at late follow-up (two weeks after the hospital discharge) and the other survived, but with signs of cardiac failure (class II of NYHA) one year after the procedure.
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PMID:[Myocardial infarction in infective endocarditis]. 794 84

A stentless porcine aortic valve was used for aortic valve replacement in 123 patients from 1987 to 1993. The mean age of 86 men and 37 women was 61 +/- 12 years. Most patients had aortic stenosis; one-third had coronary artery disease and six had mitral valve disease. The stentless valve was secured in the subcoronary position by the same technique used for a freehand aortic valve homograft. The size of valve was based largely on the diameter of the sinotubular junction of the aortic root. The mean valve size was 26.5 mm (range 19 to 29 mm) and 87% were 25 mm or larger. Two operative deaths occurred, one the result of myocardial infarction and the other the result of infective endocarditis. Patients have been followed up from 3 to 77 months, mean 22 months. Three late deaths, none related to the valve, have occurred. The actuarial survival at 6 years was 91% +/- 4%. Four transient cerebral ischemic events have occurred, but two patients had extracranial cerebrovascular disease. One patient had endocarditis late in the postoperative period and required reoperation. All patients had Doppler echocardiographic studies before discharge from the hospital, 3 to 6 months later and annually. Only 15 patients have aortic insufficiency, trivial in 6 and mild in 9. The peak and mean systolic gradients decreased significantly during the first 3 to 6 months after implantation (p < 0.001), and the effective valve areas increased significantly during this time interval (p < 0.001). This improvement in valve hemodynamics is believed to be due to remodeling of the aortic root and regression of left ventricular hypertrophy. The results of aortic valve replacement with this stentless bioprosthesis have been excellent and justify its continued use in older patients.
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PMID:Aortic valve replacement with a stentless porcine aortic valve. A six-year experience. 798 72

The relative incidence of myocardial abscesses occurring in the presence of acute or chronic ischemic heart disease is unknown. Clinical presentation usually involves nonspecific signs of sepsis, and the diagnosis often becomes apparent only when extensive myocardial destruction has occurred. Early diagnosis can greatly reduce morbidity and mortality rates. Echocardiography is a readily accessible and accurate method of diagnosing abscesses both in the presence or absence of endocarditis. We describe the appearance of a myocardial abscess complicating myocardial infarction.
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PMID:Echocardiographic diagnosis of myocardial abscess complicating myocardial infarction. 806 Jun 50

Cerebral hemorrhage occurs in 0.2% of patients under the age of 60 years treated with thrombolytic therapy for acute myocardial infarction. A case of fatal cerebral hemorrhage following TPA therapy for myocardial infarction due to probable coronary artery embolism during unsuspected native valve infective endocarditis is reported.
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PMID:Fatal intracerebral hemorrhage following thrombolytic therapy of embolic myocardial infarction in unsuspected infective endocarditis. 807 Jan 53

Bacterial endocarditis may present with acute chest pain due to coronary embolization and mimics acute myocardial infarction secondary to coronary atherosclerosis. We present the first case report of coronary embolization secondary to aortic valve endocarditis treated with standard doses of streptokinase and aspirin. The patient survived but sustained a large myocardial infarction and a major gastrointestinal bleed. Infective endocarditis should be considered in all patients presenting with acute chest pain. When myocardial infarction is due to coronary embolism from endocarditic valves standard thrombolysis regimes should be avoided.
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PMID:Acute coronary embolism complicating aortic valve endocarditis treated with streptokinase and aspirin. A case report. 808 59

We report a case of myocardial infarction with normal coronary arteriography in a 39-year-old woman presenting with tight mitral stenosis complicated by atrial extrasystoles and spontaneous atrial contrast at echocardiography. The diagnosis of coronary embolism was most probable. Coronary embolism is a rare disease, usually due to a blood clot or, less frequently, to a vegetation of endocarditis starting in a heart valve. The left network is usually involved, with typical myocardial necrosis. Coronary arteriography is sufficient to make the diagnosis. Preventive treatment is essential.
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PMID:[Coronary embolism revealing mitral valve stenosis]. 812 13

Thrombo-embolic complications including stroke and myocardial infarction are common in bacteraemic patients with and without endocarditis: about 20% of patients with infective endocarditis will develop stroke during their disease. Small miliary type myocardial infarctions are found in about 80-90% of autopsied endocarditis patients, but large myocardial infarctions are much more infrequent and acute myocardial infarctions are seldom diagnosed in the lifetime of these patients. About 10% of bacteraemic patients without endocarditis will develop stroke within one month of the onset of bacteraemia, and about 4% of bacteraemic patients will develop myocardial infarction. The risk of cerebral or myocardial infarction is very high in bacteraemic patients compared with the corresponding risk in the general population of the same age, and it has been estimated that about 10% of all strokes are associated with bacteraemic infections. The mechanisms which could cause thrombo-embolic complications in septic patients are numerous, but activation of the coagulation system is probably the most important. Currently, appropriate antimicrobial therapy is the best way to reduce mortality and also probably thrombo-embolic complications in bacteraemic patients who are not routinely using any anticoagulant therapy.
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PMID:Thrombo-embolic complications in bacteraemic infections. 813 84

Eighty patients (43 M, 37 F), aged 23-89 years who were referred for emergency echocardiography over a 12-month period were prospectively studied in order to determine the reasons for emergency echocardiography and the influence of its results on patient management. The most frequent emergency request was to clarify whether the basis for cardiomegaly in a haemodynamically unstable patient was pericardial effusion or left ventricular dilatation. Other reasons for requests were for assessment for source of systemic emboli, acute complications of myocardial infarction, endocarditis, valve dysfunction and cardiac trauma. As a consequence of the emergency echocardiography, management was immediately influenced in 19 patients. This study has provided information on the specific settings in which emergency echocardiography can be justified.
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PMID:An audit of emergency echocardiography in a district general hospital. 822 74

A 44-year-old man with aortic valve disease presented with myocardial ischaemia and ultimately infarction in the presence of suspected endocarditis. Thoracic computerised tomographic scan and coronary arteriography suggested the ischaemia was caused by external compression of the left coronary artery due to an aortic root abscess, later confirmed at surgery. Myocardial ischaemia is an infrequent accompaniment of infective endocarditis and is most commonly due to coexisting coronary disease. More rarely, emboli from vegetations may give rise to infarction. Although aortic root abscess is a well recognised complication of aortic valve endocarditis, coronary artery compression is an unusual mode of presentation and we believe this to be the first reported case of myocardial infarction resulting from external compression in this setting.
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PMID:Myocardial infarction due to coronary artery compression by aortic root abscess. 828 41

Cocaine abuse is widespread in North America. It is estimated that almost one in every four Americans has used cocaine at least once in his/her lifetime. In the past two decades, cocaine related cardiovascular complications have mushroomed because cocaine has become cheaper and more readily available. The fundamental effects of cocaine on cardiovascular system are similar to those observed following an intense, sympathetic stimulation. Cocaine intake results in marked increase in blood pressure, myocardial oxygen demand and heart rate. Coronary blood flow, which increases in response to exercise (endogenous sympathetic stimulation) however, is decreased by cocaine intake. Increased demand of oxygen by the myocardium in the face of decreased supply in subjects with cocaine use, leads to myocardial ischemia, which in turn forms a substrate for most of the cardiovascular complications, namely, myocardial infarction, cardiac arrhythmias and acute pulmonary edema. Hypertension related complications, dissection and rupture of aortic aneurysm, hemorrhagic stroke, in addition to infective endocarditis, myocarditis, cardiomyopathy all occur more frequently in cocaine addicts. In this review, pertinent clinical pharmacology and cardiovascular risks associated with cocaine abuse are presented.
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PMID:Cardiovascular effects of cocaine abuse. 829 63


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