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

Transesophageal echocardiography provides unique diagnostic capabilities, allowing for a very precise look at the structure and hemodynamics of the human heart. It is minimally invasive and portable, and quickly diagnoses sudden hemodynamic changes in intensive care patients. It provides invaluable and precise information about myocardial dysfunction and intracardiac volume status. It can diagnose dynamic left ventricular outflow obstruction, infrequent but serious complication of aortic valve replacement, septal myectomy, or mitral valve repair. Transesophageal echocardiography examination can exclude cardiac tamponade and intracardiac source of embolization, and it offers the ability to visualize native or prosthetic valves and assesses their function in the postoperative period. It is helpful in diagnosing endocarditis and the presence of intracardiac masses. In the diagnosis of blunt chest trauma, transesophageal echocardiography offers a fast and safe look at ascending and descending aorta and pericardial effusion, facilitating future decisions about patient management. In patients with postoperative hypoxia, it can exclude intracardiac shunt. Finally, in heart transplants or in managing patients with mechanical heart assist devices, transesophageal echocardiography is an invaluable tool in assessing progress of treatment and complications arising from the procedures. With the introduction of multiplane transesophageal echocardiography probes, technology, and experienced personnel, transesophageal echocardiography becomes the extension of the physical examination in the intensive care unit. This example is one of only a few whereby technology brings the physician closer to the patient.
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PMID:Transesophageal echocardiography in the intensive care unit. 1695 43

A female patient in whom idiopathic rheumatoid polyarthritis was diagnosed at the age of 8 years required surgery for severe mitral valve insufficiency 16 years later. Intraoperative analysis revealed a fibrotic endocarditis involving mainly the posterior leaflet. Granulomatous vegetations as well as a large thrombus which filled the left ventricular apex and simulated endomyocardial fibrosis were noted. Valve repair was achieved using an anterior leaflet augmentation with a patch of mitral homograft associated with a prosthetic ring annuloplasty. Postoperatively, a severe pericardial effusion required surgical drainage. Eight years later, the patient had no cardiac symptoms and echocardiography confirmed a normally functioning mitral valve.
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PMID:Valve repair for mitral insufficiency secondary to idiopathic juvenile polyarthritis. 1757 55

Hypotension and shock can be classified as hypotension caused by reduced or maintained left ventricular (LV) ejection. Reduced left ventricular ejection can result from intrinsic left ventricular, aortic valve or mitral valve failure, which includes dilated or ischemic cardiomyopathy, left main trunk disease, acute myocarditis, etc. Acute and subacute severe aortic regurgitation can also cause shock. Echocardiography allows noninvasive diagnosis of infective endocarditis and Takayasu's arteritis to cause severe arotic regurgitation and can also be used to diagnose obstruction of the left ventricular outflow tract. Reduced left ventricular preload can be caused by pericardial effusion and right ventricular ejection failure, and can result from pulmonary embolism, tricuspid regurgitation, right ventricular infarction, tension pneumothorax, hypovolemia and others characterized by a small left ventricle with good ejection fraction. Normal left ventricular ejection may be associated with hypotension. Sepsis, anaphylactic shock and neural disorder are associated with hypotension and normal cardiac output. Pseudohypotension may result from aortic dissection, Takayasu's arteritis, arteriosclerosis obliterans and aortic coarctation. A right parasternal approach enables better visualization of the ascending aorta. Fundamental echochocardiographic scanning allows approximate yet useful diagnosis of hypotension and shock.
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PMID:[Easy echo diagnosis for hypotension and shock]. 1908 1

Systemic infection with Aspergillus is an opportunistic disease that affects mainly immunocompromised hosts, and is associated with a high mortality rate. It typically occurs in patients with several predisposing factors, but Aspergillus endocarditis of native valves is rare and experience in diagnosis and treatment is limited. We report a case of native valve endocarditis caused by Aspergillus. A 35-yr-old male patient who underwent pericardiocentesis four months previously for pericardial effusion of unknown etiology presented with right leg pain and absence of the right femoral artery pulse. Cardiac echocardiography revealed severe mitral insufficiency with large mobile vegetations, and computed tomographic angiography showed embolic occlusion of both common iliac arteries. We performed mitral valve replacement and thromboembolectomy, and Aspergillus was identified as the vegetation. We started intravenous amphotericin B and oral itraconazole, but systemic complications developed including superior mesenteric artery aneurysm and gastrointestinal bleeding. After aggressive management, the patient was discharged 78 days post surgery on oral itraconazole. He was well at 12 months post discharge but died in a traffic accident 13 months after discharge.
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PMID:Surgical treatment of native valve Aspergillus endocarditis and fungemic vascular complications. 1927 Aug 34

Noonan syndrome is an autosomal dominant dysmorphic syndrome. Pulmonary stenosis is the most common cardiac anomaly in Noonan patients, with an incidence of 60%. A 9-year-old girl was referred to our institution with pericardial effusion. Transthoracic echocardiography indeed confirmed massive pericardial effusion and revealed, further, valvular and arterial pulmonary vegetations that accompanied a dysplastic tricuspid pulmonary valve. We decided to perform emergency pericardial tube drainage and to continue the anti-biotic regimen for 2 more weeks before undertaking open-heart surgery. After 2 weeks, the patient underwent an operation wherein the valvular vegetations were excised and a pulmonary valve commissurotomy was performed, yielding a competent pulmonary valve with 3 distinct but moderately dysplastic cusps. In addition to the pulmonary valve, the main, left, and right pulmonary arteries were filled with mobile vegetations, which were removed during the procedure. In this patient, a dysplastic and stenotic pulmonary valve may have contributed to the progression of endocarditis and to the growth of vegetations that occupied the pulmonary arteries. In conclusion, we hypothesize that although pulmonary stenosis is not considered a common predisposing factor for infective endocarditis, it can contribute to the progression of infective endocarditis in Noonan patients.
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PMID:Pulmonary stenosis as a predisposing factor for infective endocarditis in a patient with Noonan syndrome. 2020 Jun 38

This paper describes a case of a 44-year-old male patient previously healthy admitted with an unusual spontaneous acute bacterial pericarditis associated with coronary sinus mass. Two-dimensional echocardiography showed large loculated pericardial effusion with signs of diastolic restriction and an image suggesting vegetation in topography of the right atrium coronary sinus. Pericardial drainage, coronary sinus vegetation resection, and antibiotic therapy with Oxacillin were performed due to Oxacillin-susceptible Staphylococcus aureus identified on the pericardial effusion and blood culture. This is a rare condition and a unique combination of a spontaneous acute bacterial pericarditis with coronary sinus endocarditis without cardiac valve compromise.
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PMID:Spontaneous Bacterial Pericarditis and Coronary Sinus Endocarditis Caused by Oxacillin-Susceptible Staphylococcus aureus. 2058 70

Transient effusive-constrictive pericarditis is a rare complication of open-heart surgery, but is increasingly recognized. For patients with both pericardial effusion and constrictive physiology soon after uneventful open-heart surgery, proper treatment remains to be established. We experienced a case of transient effusive-constrictive pericarditis in a 50-year-old woman who underwent aortic valve replacement due to infective endocarditis. Initially, she was treated with both prednisolone and ibuprofen, which resulted in dramatic relief of symptom. However, she suffered from a relapse of pericaridis after rapid steroid discontinuation and was stabilized by re-treatment with steroid.
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PMID:Recurrent postoperative effusive-constrictive pericarditis associated with steroid discontinuation. 2066 25

A 71-year old man with sepsis, hemorrhagic pericardial effusion and pulmonary embolism was admitted on the intensive care unit. In blood cultures and in pericardial effusion, Staphylococcus aureus was isolated. Transeosophageal echocardiography showed a massive pulmonary valve endocarditis. Right-sided endocarditis is a rare variant of endocarditis and may occur in consequence of contaminated drug solutions or infected intravenous catheter. The prognosis is relatively good, worse prognosis show fungal infections and vegetation with a length >20 mm.
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PMID:[71-year old patient with sepsis, pericardial effusion and pulmonary infiltrates]. 2125 81

Chylopericardium after cardiac surgery is rare, and there are few reports of its occurrence after aortic valve surgery. Chylous pericardial effusion 4 months after aortic valve replacement for endocarditis is highly unusual.Herein, we report the case of a 54-year-old man who had undergone bioprosthetic aortic valve replacement because of endocarditis and valvular dysfunction. Two months later, he underwent pericardiocentesis twice because of large pericardial effusions consisting of pinkish white fluid with predominant lymphocytes. Four months after valve replacement, he presented with recurrent effusion consistent with early tamponade, and a pericardial window was created. At surgery, 1,500 cc of milky white fluid was recovered, and the diagnosis of chylopericardium was made. Postoperative high-volume drainage prompted thoracic duct ligation, which was curative.
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PMID:Delayed chylous pericardial effusion after aortic valve replacement. 2184 77

Listeria monocytogenes, although an uncommon cause of illness in the general population, is feared principally because of the morbidity and mortality associated with CNS infections. Cardiovascular involvement with L. monocytogenes is very rare, and has been limited to endocarditis. We describe a case of Listeria pericarditis, which occurred in a 60-year-old man with Child-Pugh B cirrhosis who presented to the emergency department with asthenia, anorexia, and respiratory distress. The echocardiogram showed severe pericardial effusion and after pericardiocentesis, L. monocytogenes was isolated in the culture of pericardial fluid. After surgical pericardiectomy with draining of the pericardial effusion and antibiotic treatment with ampicillin, the patient experienced a slow, but full recovery. Documentation of L. monocytogenes pericarditis is an extremely rare entity with very scarce reports in medical literature, and is usually associated with a very poor prognosis. A case report is presented together with a review of the literature.
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PMID:Successful management of Listeria monocytogenes pericarditis: case report and review of the literature. 2189 16


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