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

Transthoracic two-dimensional echocardiography (TTE) has been an accepted noninvasive procedure used to diagnose infective endocarditis by demonstrating the presence of vegetations and other complications such as ring abcess, mycotic lesions or sinus of valsalva aneurysm. Moreover, complementary Doppler and Color Flow imaging are very useful in detecting early valvular regurgitation and in evaluating the severity of such regurgitant lesions. Occasionally, TTE fails to provide an adequate quality of imaging because of the patient's obesity, chest deformity or emphysema. Transesophageal echocardiography (TEE) on the other hand, a relatively new technique, allows ultrasonic imaging of the heart through the esophagus and provides a clear visualization of all cardiac structures without any interference from the lungs, chest wall or rib cage. We present a case of aortic valve endocarditis diagnosed by TEE.
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PMID:Transesophageal echocardiography (TEE): its diagnostic value in endocarditis. 227 24

1. Laennec's lung disease lasted for at least 20 years. Its stigmata included chronic cough, sputum production and intermittent wheeze. 2. Laennec had long term stigmata commonly associated with chronic bronchiectasis, sinusitis, physical frailty, and short stature (5ft 2in). 3. Chronic diarrhoea of at least 20 years duration is not strongly associated with tuberculosis. 4. During Laennec's last illness his physicians equivocated as to whether he had respiratory disease at all. Bronchial breathing at the apex, if indeed present, could have been caused by compensatory emphysema secondary to middle lobe bronchiectasis rather than to active tuberculosis. 5. Laennec did not have haemoptysis in his final illness. 6. Laennec's last illness, a wasting illness characterised by intermittent fevers, cardiac murmur, and persistent tachycardia followed a dental manipulation. The painful "abdominal abscess" noted by Laennec's colleagues may actually have been splenomegaly. These features suggest endocarditis. The cardiac murmurs associated with pulmonary hypertension secondary to bronchiectasis are not usually audible at a remote distance from the patient. Endocarditis was a disease largely unknown to physicians of the early 19th century before Osler clarified its pathology in the 1880s.
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PMID:Rene Laennec: his brilliant life and tragic early death. 266 72

Up to 10% of patients may have bacteremia after rigid sigmoidoscopy. The aim of our study was to determine the frequency of bacteremia accompanying flexible sigmoidoscopy. Blood samples for aerobic and anaerobic cultures were obtained before, during, and after flexible sigmoidoscopy in 100 patients who were examined a mean distance of 49.5 cm, range 15-60 cm, after a bowel preparation of two Fleet enemas. In one patient, a transient bacteremia with Streptococcus intermedius was documented and was attended by no associated clinical manifestations. This organism has been previously isolated from patients with endocarditis, peritonitis, emphysema, and hepatic and appendiceal abscesses. There was no association in our study with bacteremia and such factors as length of bowel examined and duration of procedure, the presence of bowel pathology, performance of endoscopic biopsies, liver disease, and portal hypertension or poor bowel preparation. We conclude that the extremely low incidence of significant bacteremia with flexible sigmoidoscopy may be related to the smaller diameter of the instrument and provides further support for the routine use of flexible rather than rigid sigmoidoscopy.
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PMID:Does bacteremia occur during flexible sigmoidoscopy? 402 78

Transoesophageal echocardiography in a routine setting in a small Norwegian district hospital (catchment area population 30,000) during a 12-month period is presented. The method is relatively new and is seldom used at district hospitals. We therefore find it of interest to report our experience with the method. During 1998 a total of 868 echocardiographies were performed, 167 of which were transoesophageal. Our hospital had at that time three people performing the investigation, two of which were cardiologists. The mean age of patients was 69.9 years; men 68.4, women 71.8 years. 60% of the investigations were on inpatients; 40% of the transoesophageal investigations were performed as emergencies or subacutely. The transoesophageal echoes were performed following the usual application criteria: 56 were done to evaluate possible cardial source of embolism, 32 valve disease, 24 to verify or follow endocarditis, 14 patients were seen prior to electroconversion. In six of these, large thrombi in the left-side cardiac chambers were found and electroconversion was not performed. All these patients had been on well controlled anticoagulant treatment for three or more weeks prior to the investigation. Seven patients were studied due to probable aortic pathology. Patients with emphysema, chronic lung disease, radiation sequelae or others with no parasternal or subxiphoid access had transoesophageal echo performed. Intravenous diazepam was only used in four of 167 investigations. This was of great importance for including the method in our outpatient clinic routine. The frequent observation of intracardiac thrombi has let us to incorporate transoesophageal echocardiography into a routine setting for all patients prior to electroconversion and for those with stroke in order to optimise treatment.
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PMID:[Transesophageal echocardiography at a small Norwegian district hospital]. 1130 12

A 72-year-old man was treated for fungal tricuspid valve endocarditis (TVE) with significant tricuspid valvular regurgitation and severe congestive heart failure caused by Candida parapsilosis. The patient had received hyperalimentation and antibiotic therapy for three months through a central venous catheter after the surgical treatment of ileus. The patient was treated medically with amphotericin B and fluconazole because of high surgical risk due to severe pulmonary emphysema, and he responded well. Although TVE caused by C. parapsilosis is rare, we should consider this possibility in patients receiving long-term hyperalimentation and antibiotic therapy using a central venous catheter.
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PMID:Isolated tricuspid valve endocarditis due to Candida parapsilosis associated with long-term central venous catheter implantation. 1139 10

1. The oxygen content of venous and of arterial blood from fifteen essentially normal individuals at rest in bed has been determined. 2. The percentage saturation of the arterial blood has varied between 100 and 94.3. The average is 95.5 per cent. 3. The oxygen consumption has varied between 2.6 and 8.3 volumes per cent. 4. The oxygen content and the percentage saturation of arterial blood taken at close intervals from three different peripheral arteries of a normal individual have shown values agreeing within the limits of error. Analyses of the blood gases of a normal individual, at rest and after exercise, have shown a lowering of the percentage oxygen saturation of the arterial blood and a diminished carbon dioxide content after exercise. 5. In three persons with severe anemia the saturation of the arterial blood has not differed from the normal. Very low absolute values were found for the oxygen content of the venous blood, but the normal oxygen consumption has been maintained. 6. The carbon dioxide content of the arterial blood from ten normal individuals has varied between 54.7 and 44.6 volumes per cent. That of the venous blood has varied between 60.4 and 48.3 volumes per cent. 7. No deviations from the normal values for oxygen and carbon dioxide were found in venous and arterial blood from cardiac patients without arrhytiunias, well compensated, and at rest in bed. 8. A series of determinations has been made upon nine cardiac patients with varying degrees of decompensation. The percentage oxygen saturation of the arterial blood on admission was abnormally low in seven of these cases. With the return to compensation and with the clearing up of pulmonary symptoms, the percentage saturation of the arterial blood returned to normal in four of them. 9. In a case of long standing mitral endocarditis with auricular fibrillation it remained low over a period of I month of observation. 10. In a case of chronic myocarditis secondary to emphysema and chronic bronchitis, it remained low over the period of observation. 11. Normal values for the percentage saturation of the arterial blood were found in two individuals with decompensated aortic disease but without physical signs of extensive pulmonary involvement. 12. The oxygen consumption tended to be high in individuals with cardiac disease during the periods of marked decompensation and to be lower as compensation was regained. 13. The data presented indicate that at least in many circulatory diseases during decompensation, particularly when there are physical signs of pulmonary congestion, there is a disturbance of the pulmonary exchange, as indicated by the lowering of the percentage saturation of the arterial blood with oxygen.
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PMID:THE OXYGEN AND CARBON DIOXIDE CONTENT OF ARTERIAL AND OF VENOUS BLOOD IN NORMAL INDIVIDUALS AND IN PATIENTS WITH ANEMIA AND HEART DISEASE. 1986 56