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

Within a period of three months indications and diagnostic as well as therapeutic consequences of all echocardiographic studies were investigated in a middle-size hospital. 174 of a total of 188 examinations were usable. Most examinations were performed in order to detect or to verify left-ventricular failure or coronary heart disease. The diagnostic and therapeutic consequences were enormous; more than 90% of all pathological findings were listed as diagnoses in the final medical report. In terms of valvular heart disease, pericardial effusion and left-ventricular failure the echocardiographic study was most essential for diagnosis. In contrast most normal findings were seen with suspicion of coronary heart disease. Changes in medication or new prescription of oral anticoagulation, ACE inhibitors and beta-adrenergic antagonists were significantly related to the therapeutic recommendations of the echocardiographic studies. The recommendations concerning antibiotic prophylaxis of endocarditis or further diagnostic investigation were respected with few exceptions. Obviously little conclusion could be drawn from a normal echocardiographic study; a well-established indication is essential for the benefit of echocardiography.
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PMID:[Indications for, diagnostic conclusions and therapeutic consequences of echocardiography. Studies in a medium-sized hospital]. 772 53

We describe the cardiovascular abnormalities found at autopsy in patients with AIDS and a description of the opportunistic infections in these cases studied between January 1988 and August 1993. There were 51 cases with such diagnosis. Pericardial effusion appeared in 9, pleural effusion in 7, myocarditis in 5, 7 with pericarditis, endocarditis in 6, left ventricular hypertrophy in 20, right ventricular hypertrophy in 21 and evidence of atherosclerosis in 15. Thus, data of cardiovascular damage was present in 42.7% of our patients. The cardiovascular abnormalities in this group are common, in contrast to the paucity of clinical findings. Diagnosis of cardiac pathology was made in only 12% of them. So in every case with diagnosis of AIDS, a careful clinical examination and cardiac diagnostic oriented tests must be done for detection of these abnormalities.
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PMID:[The autopsy findings in 51 cases of AIDS with cardiovascular damage]. 784 Jul 32

A 69-year-old man was transferred to our hospital because of severe progressive heart failure, eyeground hemorrhage due to embolism and uncontrollable inflammation. Emergent operation was suggested. Aortic valve replacement with a 23 mm Carpentier-Edwards bioprosthesis and patch closure of perforation using Dacron double velore was successfully performed. Vegetation was observed from the commissure between left and non coronary cusp to the aortic wall. Perforation (3 mm in diameter) and a moderate amount of bloody pericardial effusion were recognized. However periannular abscess was not detected. Postoperative course was uneventful and no recurrence of infection has been seen. We believe that surgical treatment for active infective endocarditis should be recommended when the bactericidal agents are ineffective and before the hemodynamics is suddenly deteriorated and the embolism occurs to the other organs.
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PMID:[Successful surgical treatment of active infective endocarditis associated with perforation of aortic wall]. 788 66

During the past ten years, two-dimensional echocardiography has become a major tool in the assessment of cardiovascular diseases. With the advent of pulsed, continuous wave, and color flow Doppler, the field of echocardiography is now accepted as the ideal noninvasive technique for assessing left and right ventricular function; determining valvular stenosis or regurgitation; assessing pericardial disease (i.e., constrictive pericarditis, pericardial effusion); determining diastolic dysfunction; estimating pulmonary artery pressures; examining for cardiac source of emboli; and evaluating for endocarditis. During the past five years, semi-invasive applications have included intracardiac echocardiography, guiding pericardiocentesis, assisting in percutaneous mitral valvotomy, catheter placement for ablation procedures, optimizing pacemaker hemodynamics, and using contrast agents to assess myocardial viability. With the miniaturization of transducers, bioengineers have developed probes small enough to be incorporated into the tip of a flexible gastroscope, thus accelerating the development of one of the most exciting and innovative techniques in cardiology, transesophageal echocardiography.
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PMID:Transesophageal echocardiography. 796 15

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

Echocardiography has contributed considerably to the evolution in the management of patients with infective endocarditis. There is a clear hierarchy with respect to sensitivity of the different methods is superior when compared to 2-D and M-mode echocardiography in identifying both vegetations and perivalvular complications e.g. abscess formation, aneurysms, mural endocardial lesions. For patients with suspected endocarditis, in whom vegetations can not be clearly identified or in whom abscess formation is suspected with transthoracic echocardiography (TTE), transesophageal echocardiography (TEE) with mono- or multiplane scans has become the standard diagnostic procedure. For the examination of prosthetic valves it is the method of choice. It has even been suggested that it is employed as routine measure in all patients with suspected infective endocarditis. TEE is a safe semi-invasive technique with an extremely low complication rate and high sensitivity. Its specificity depends largely on the patient group which is examined. In patients with indicative clinical symptoms the specificity and the predictive value of vegetations are high. When used as screening method to assess echodense formations at cardiac valves particularly in the elderly, in whom degenerative changes prevail, its specificity and positive predictive value of vegetation-like structures are much lower. The negative predictive value of a negative transesophageal echocardiogram remains high, however. Valve abscesses are detected rarely by transthoracic echocardiography. It is the domain of TEE to assess them particularly in the aortic and mitral valve area. For them the specificity and positive predictive value of TEE in the diagnosis of infective endocarditis is high again. Of further importance was the observation that patients with vegetations of > 10 mm were more likely to suffer embolic complications. It should be noted, however, that infective endocarditis remains a clinical diagnosis: neither is the demonstration of a vegetation already the equivalent of endocarditis, nor does missing vegetations completely rule out the possibility of it. But without doubt, the presence of vegetations, of abscess formation or a concomitant pericardial effusion add valuable information to clinical diagnosis of infective endocarditis, which still needs a "high index of suspicion".
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PMID:Value and limitations of transesophageal echocardiography in infective endocarditis. 830 51

Infective endocarditis is a life-threatening disease which may be complicated by ring-valve abscess. Since this complication increases morbidity and mortality early diagnosis is important. Pericardial effusion complicating infective endocarditis is uncommon and should raise suspicion of the presence of an abscess. We describe 2 patients admitted for infective endocarditis and pericarditis. In both, ring-valve abscess was suspected on clinical grounds. At surgery there was pathological confirmation of the diagnosis. Both patients underwent successful aortic valve replacement with complete recovery. Controlled trials are providing increasing evidence for the superiority of transesophageal echocardiography in detecting valvular vegetations. Moreover, it is the most accurate means of detecting ring-valve abscess in cases of infective endocarditis. In view of these advantages, we propose the use of transesophageal echocardiography in every case of infective endocarditis.
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PMID:[Ring-valve abscess--a diagnostic challenge]. 849 34

Fifty patients in stage IV of HIV infection (including 41 AIDS patients) were prospectively studied by echocardiography. Thirteen of them showed abnormalities: 4 had pericardial effusion, 1 endocarditis, 7 myocardial disorders and 1 primary pulmonary arterial hypertension. Pericardial effusion, also present in patients who had pleuropulmonary Kaposi's sarcoma, was not specific. Myocardial disorders concerned the diastolic function in 1 case, the segmental kinetics in 2 cases and the whole systolic function in 4 cases (3 had congestive myocardiopathy and 1 had transient systole alteration without left ventricular dilatation). The mechanism of global left ventricular disorders was multifactorial, and several hypotheses were discussed: infectious myocarditis, adrenergic or nutritional deficiency myocarditis, cardiotoxicity of antiviral drugs, common pathology with HIV encephalopathy. The prognosis of congestive myocardiopathy was poor in AIDS patients and undetermined in stage IV non-AIDS patients. Echocardiography is capable of detecting these lesions, and its use may contribute to a better care of these patients.
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PMID:[Echocardiographic abnormalities in the stage IV of HIV infection]. 851 Nov 25

Imaging procedures are important for diagnosis and surveillance of patients in intensive care units. Radiologic examination, ultrasound and echocardiography are of paramount importance because they can be done bedside. Portable chest x-ray examination is the procedure of choice for documentation of tubes, lines and devices, estimation of cardiopulmonary function, demonstration of pulmonary edema, ARDS pneumonia, atelectasis and pneumothorax Plainfilm radiologic imaging of the abdomen is indicated when perforation ileus or acute intestinal pseudoobstruction is suspected Echocardiography can give information about ventricular function, pericardial effusion, cardiac valves, functional importance and complications of myocardial infarction, and hemodynamic changes of pulmonary embolism. Transesophageal echocardiography (TEE) is the method of choice when endocarditis, aortic dissection or cardiac thromboembolism is considered. Ultrasound can show many pathologic changes important for the management of intensive care patients concerning liver, gallbladder, bile duct, pancreas, kidney, spleen, pleural space and vessels. Other imaging procedures such as CT, methods of nuclear medicine, MRT, angiography etc. are done outside the intensive care unit and therefore need a more restricted indication.
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PMID:[Imaging methods in intensive care]. 865 7

We report a case of neonatal lupus erythematosus (NLE) with congenital heart block and severe myocardial failure, which was followed from the 25th week of gestation because of fetal bradycardia. The child was delivered at the 37th week of gestation by elective cesarean section because of echocardiographically documented heart enlargement, pericardial effusion and moderate insufficiency of the mitral and tricuspid valves. In spite of immediate pacing, intubation and supportive treatment, the newborn developed progressive heart failure. Echocardiography showed endocarditis of the mitral valve and diffuse myocarditis. The heart failure resolved under steroid treatment. Our experience supports the early use of steroids in treating myocarditis due to NLE. Intrauterine steroid treatment in the presence of fetal hydrops and congenital heart block is discussed.
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PMID:Neonatal lupus erythematosus with congenital heart block and severe heart failure due to myocarditis and endocardititis of the mitral valve. 879 3


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