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

Significant medical complications after elective abortion are rare. However, complications do occur, and the emergency physician should always bear this in mind when evaluating a patient with significant illness who has recently undergone an elective abortion. Reported here is a case of postabortion endocarditis, manifesting as a septic coronary artery embolism, that led to a fatal acute myocardial infarction.
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PMID:Fatal myocardial infarction resulting from coronary artery septic embolism after abortion: unusual cause and complication of endocarditis. 899 2

A 65-year-old man was hospitalized with persistent fever (up to 39 degrees C) of 3 weeks' duration 9 years after aortic valve replacement with a Hall-Kaster prosthesis. Multiple blood cultures demonstrated beta-Streptococcus. Transesophageal echocardiography disclosed mobile vegetations at the prosthetic valve with normal valve function. A diagnosis of late prosthetic valve endocarditis was made. Therapy was begun with penicillin G, cefazolin, and gentamycin. On the 20th hospital day, he suddenly developed severe chest pain. Electrocardiography was consistent with acute extensive anterior myocardial infarction. Coronary angiography revealed that the left anterior descending coronary artery was occluded in its proximal portion with an intraluminal filling defect, which was morphologically the same as the vegetation that had been demonstrated previously. Percutaneous transluminal coronary angioplasty was performed, and coronary artery perfusion was restored 4.5 hours after the onset of chest pain. Transesophageal echocardiography performed 2 days later revealed that the vegetation at the prosthetic valve level had nearly disappeared. This is the first reported case of coronary angioplasty in a patient with acute myocardial infarction caused by prosthetic valve endocarditis in Japan.
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PMID:[Successful coronary angioplasty in a patient with acute myocardial infarction caused by prosthetic valve endocarditis]. 906 26

Focal deficits, seizures and epilepsy, altered consciousness, and disturbed behaviours can complicate heart diseases and their medical treatment as well as cardiological procedures and cardiac surgery. Neurological complications of common cardiac conditions are discussed. These cardiac conditions are acute myocardial infarction and ischaemic heart disease, atrial fibrillation and cardiac arrhythmias, congestive heart failure, valvular heart diseases, infective endocarditis, congenital heart disease, invasive cardiological procedures and cardiac surgery. As transient ischaemic attack, stroke, seizures and epilepsy are the most common neurological complications, their management is also reviewed. Precautions should be taken to prevent neurological complications of heart disease. Regular surveillance for these complications would allow early diagnosis and initiation of appropriate management.
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PMID:Neurological complications of heart disease. 948 97

We report a 24-year-old man with mitral valve endocarditis complicated by acute myocardial infarction due to coronary embolism. Percutaneous transluminal coronary angioplasty and subsequent mitral valve replacement were performed. Postoperative coronary angiography revealed formation of a mycotic aneurysm of the left anterior descending coronary artery at the site of balloon inflation. The patient then underwent successful resection of the aneurysm with coronary artery bypass grafting.
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PMID:Mycotic aneurysm of the left coronary artery. 952 31

The authors present the cases of two young patients, a man and a woman, who presented with myocardial infarction, in the absence of ischemic heart disease or stenosis of the coronary arteries. The woman was known to have systemic lupus erythematosus (SLE) for the past 3 years (the immunoglobulin M [IgM] anticardiolipins antibodies were positive), without a history of coronary risk factors. Suddenly she presented with acute chest pain on rest that lasted 4 hours and culminated in anterior wall myocardial infarction. She was admitted to the coronary care unit, where no thrombolysis was given. She did not have echocardiographic evidence of Libman-Sacks endocarditis, but myocardial infarction was evident at the electrocardiogram (ECG). The young man had SLE (the IgM anticardiolipins were absent, but he was positive for lupus anticoagulant antibodies), he was hyperlipidemic, was a moderate smoker and moderately obese, and had no history of ischemic heart disease. He suddenly presented with an acute myocardial infarction documented by ECG, enzymes, and gammagraphy. In both patients, coronary angiography findings were normal and myocardial biopsy did not show evidence of arteritis. The relevance of these cases is the rare association of ischemic heart disease in SLE, with normal coronary arteries and without evidence of arteritis or verrucous endocarditis.
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PMID:Myocardial infarction in patients with systemic lupus erythematosus with normal findings from coronary arteriography and without coronary vasculitis--case reports. 1008 5

A growing amount of epidemiologic, experimental, and clinical evidence has linked infection as a risk factor to variousatherosclerotic diseases including acute myocardial infarction and cerebral infarction. Bacteremic infections with and without endocarditis carry a high risk for both stroke and acute myocardial infarction. During the last decade, chronic bacterial infections such as Chlamydia pneumoniae and dental infections have been associated as risk factors for various atherosclerotic diseases. These chronic bacterial infections are risk factors for acute cardiovascular events, but they may also have some role in the etiopathogenesis of atherosclerotic process itself. There are many known mechanisms that might explain the observed association of infection and atherosclerotic diseases, but it is probable that these mechanisms are complex and multifactorial and probably differ from infection to infection and from patient to patient. Infection theory is by no means against classic risk factor theory in the etiopathogenesis of atherosclerosis. Infection may also act as a synergistic risk factor together with classic risk factors in the development of various atherosclerotic diseases.
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PMID:Role of infections in atherosclerosis. 1053 42

The morphological findings in eight explanted Toronto SPV bioprostheses were described. Clinical records were reviewed for patient information and data regarding the explanted bioprosthesis, all of which were analyzed in detail by gross and histological examination. All valves were also examined radiologically and detailed specimen photographs obtained. When warranted, tissue cultures were taken and special stains for microorganisms obtained. The Toronto SPV bioprosthesis has been used for aortic valve replacement in 270 patients since its introduction in 1991. The follow-up evaluation was 99.5% complete. Eight valves have been explanted: three at surgery and five at autopsy. Patient age ranged from 35 to 69 years, with five male and three female patients. Indications for aortic valve replacement were aortic stenosis in all cases. Implant duration ranged from 5 weeks to just over 6 years (mean 38 months). Early failures (2) were due to infective endocarditis. Two patients died of acute myocardial infarction, related to pre-existing coronary artery disease, and two died from lung cancer. All late explants showed host tissue growth (grade 2-3), with variable extension onto both the proximal and distal suture lines, as well as extension onto the cusps and commissures on the flow and nonflow surfaces. Extension of pannus onto native aortic tissues was seen but did not encroach on the coronary ostia. Tissue degenerative changes were present, as were small tears (type 1) in two valves. Mild calcification was seen in two valves. The Toronto SPV has excellent clinical performance at up to 8 years of follow-up evaluation. In this series, early failures are related to infective endocarditis, and later explants (6 of 8) are associated with mild tissue degeneration and an occasional cusp tear. At up to 5 years, only minimal/mild calcification was seen in two of the eight valves.
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PMID:The Toronto SPV bioprosthesis: review of morphological findings in eight valves. 1066 Jan 85

At least 20% of all ischemic strokes are cardioembolic. Cardiac conditions that cause cerebral embolism are classified as major or minor depending on whether the causal link has or has not been fully established between the underlying cardiac condition and the stroke. Atrial fibrillation, acute myocardial infarction, valvular heart disease, infective endocarditis, nonbacterial thrombotic endocarditis, and atrial myxoma are the main cardiac causes of cerebral embolism. Patent foramen ovale, atrial septal aneurysm, mitral valve prolapse, mitral annular calcification, calcific aortic stenosis, and mitral valve strands are cardiac conditions with a potential causal link to cerebral embolism, but until now, either they have been found to be poor predictors of recurrent stroke or their risk of recurrent stroke is unknown. The management of patients with a stroke of cardiac source is twofold: 1) treatment of the acute phase of stroke and 2) prophylactic treatment of recurrent thromboembolism. When possible, primary prevention of cerebral embolism should be recommended, particularly in cardiac conditions with known high risk of stroke (eg, atrial fibrillation, mitral stenosis, or presence of mechanical prosthetic heart valves).
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PMID:Cardiac Causes of Stroke. 1109 56

Cardiac failure due to valvular dysfunction is frequent as a complication of acute myocardial infarction, endocarditis or penetrating thoracic trauma affecting the heart and large vessels. Less frequently it is associate with nonpenetrating chest trauma. We presented a 69-year-old male with acute left heart failure after nonpenetrating thoracic trauma and sternum fracture. Transesophageal echocardiogram confirmed severe aortic regurgitation. A bilateral tear in the right coronary and non-coronary cusp was found. The aortic valve was removed and replaced with a number 27 Carpentier Edwards prosthesis. The postoperative course was uneventful.
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PMID:[Cardiac failure due to traumatic aortic valve rupture]. 1141 86

Left atrial dissection is an uncommon entity. It is generally associated with mitral valve replacement, but other predisposing factors should be considered in pathogenesis. We discuss a series of 11 patients with pathologically confirmed left atrial dissection who had been diagnosed previously by transesophageal echocardiography. Predisposing factors and surgical or pathologic findings were reviewed to identify the pathogenic mechanism and to explain the clinical course, hemodynamic disorder, and echocardiographic features. Dissection of the coronary sinus secondary to retrograde cardioplegia, endocarditis, cardiac rupture after myocardial infarction, and blunt chest trauma also could be related to its development. Transesophageal echocardiography identified a mobile intimal flap of the atrial wall that was creating a false chamber and allowed accurate diagnosis of prosthetic mitral valve function, endocarditis complications, and a left ventricular pseudoaneurysm after acute myocardial infarction. Color flow Doppler was particularly useful in identifying complications: communication between the false chamber and true left atria, permitting mitral regurgitation through the periannular route; development of atrial shunts; and severe tricuspid regurgitation caused by disruption of the anterior papillary muscle.
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PMID:Left atrial dissection: pathogenesis, clinical course, and transesophageal echocardiographic recognition. 1149 Mar 30


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