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

A 40-year-old woman with staphylococcus aureus endocarditis of the mitral valve associated with acute pulmonary edema and renal dysfunction is presented. The patient was admitted to Hiroshima University Hospital with infective endocarditis. On the 14th day after admission, she suffered from severe cardiac failure and oligouria, then she was transferred ICU. Chest X-ray film showed pulmonary congestion and echocardiogram revealed 4th grade of mitral valve regurgitation. Emergent mitral valve replacement was performed and rupture of anterior mitral chorda was found as the cause of acute pulmonary edema. Postoperative care was difficult because of advanced renal failure and cardiac failure not responded to diuretics. Extracorporeal ultrafiltration method was effectively used on the 1st and the 2nd postoperative days and 3000 ml of water was filtered without hemodynamic change. Symptoms of renal and cardiac failure recovered promptly after ultrafiltration. Emergent operative and postoperative use of ultrafiltration method is effective in some cases of infective endocarditis complicated with cardiac and renal failure.
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PMID:[A case report of infective endocarditis with acute pulmonary edema and renal dysfunction treated by emergent mitral valve replacement and postoperative extracorporeal ultrafiltration]. 280 98

The authors report 2 cases of thrombolytic therapy by Urokinase at the dose of 4 500 U/kg/hour, for 24 hours, in patients with thrombosis of a Bjork aortic and Lillehei mitral valve prostheses, and assess the efficacy with a review of the world literature. The first case was a 65 year old woman who received a Bjork No 25 aortic valve prosthesis for aortic regurgitation. Two years later oral anti-vitamin K anticoagulants were replaced by an association of Aspirin-Persantine. She developed acute pulmonary oedema secondary to thrombosis of her valve during the fifth postoperative year. Treatment with Urokinase was successful (4 500 U/kg/hour for 24 hours). The second cases was a 33 year old woman who received a Lillehei No 27 mitral valve prosthesis for mitral regurgitation due to infective endocarditis. Six years later, during a period of apparently ineffective oral anticoagulation, she developed subacute pulmonary oedema due to thrombosis of her prosthesis. Urokinase therapy was successful after 4 hours, but the valve surface area on cardiac catheterisation was decreased and elective reoperation to change the prosthesis was decided upon. Prosthetic valve thrombosis is a serious complication with an operative mortality of 68.6% (35 deaths out of 51 reoperations in the worl literature) whilst the efficacy of thrombolytic therapy would appear to be about 80%. When thrombosis is progressive, the valve has to be changed surgically, but when it is secondary, thrombolytic therapy at least helps the patient survive the acute phase.
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PMID:[Role of thrombolytic treatment in thrombosis of valvular prostheses. Apropos of 2 cases and review of the world literature]. 643 46

Among 369 patients with native valve infective endocarditis observed during a 14-year period, 17 were related to S: pneumoniae. Fourteen of them were observed in the last 7 years. At the time of admission 13 exhibited purulent meningitis, 6 of them being comatose. An apparent portal of entry was present in 13 patients including Pneumonia (n = 11) and otitis media (n = 2). Major alcoholism was present in 6 cases. The mean delay between the onset of fever and the discovery of the cardiac murmur was 15 days (range 1 to 60). Twelve patients exhibited congestive heart failure with acute pulmonary oedema in 9. The aortic valve was involved in 12 and the mitral valve in 7 (in 2 patients both mitral and aortic valves were involved). Myocardial and/or annular abscesses were found in 7 patients. Nine patients underwent surgical procedure (3 died) whereas 6 comatose patients were not operated on and died. The overall mortality was 59%. Although antibiotics are effective, the severity of anatomical lesions leads to prompt surgical treatment. The high mortality is mainly due to purulent meningitis.
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PMID:Pneumococcal endocarditis. 651 90

Drug-addicts frequently suffer from pulmonary diseases, particularly those who practice self-injection of the drugs intravenously. Emphasis is at present laid on the various excipients which are thought to induce acute alveolitis with subsequent acute pulmonary oedema in heroin-addicts. It has also been suggested that the deep ventilatory depression that precedes pulmonary oedema may play a part and this is interesting since the depression can now be prevented with naloxone. Infectious lesions, such as septic pulmonary embolism or endocarditis, are easier to explain. The ever increasing use of tablets crushed for injection is responsible for peri-arteriolar granulomas of the lung with possibly severe sequelae. Finally, the almost generalized consumption of marihuana in the United-States has led to the discovery of new properties of this drug, including ventilatory stimulation and broncho-dilatation. However, this is mostly of theoretical interest. The psychotropic effects of marihuana and its irritant effect on the bronchi when inhaled make it unlikely that it will be ever be used for therapeutic purposes.
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PMID:[Pneumopathies in drug addicts]. 663 69

A 63-year-old man with cough and shortness of breath was diagnosed to have active infective endocarditis resulting in acute pulmonary edema with aortic regurgitation caused by a huge vegetation on the noncoronary cusp and left ventricular-right atrial (LV-RA) communication which were demonstrated by the echocardiogram and color doppler method. The LV-RA communication located at the atrioventricular portion of the membranous septum was closed with GoreTex patch through the right atrium combined with the aortic valve replacement with a bileaflet mechanical valve in emergency. The bacteriological studies demonstrated staphylococcus epidermidis. The postoperative course was uneventful and the patient is now on regular duty two years after surgery.
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PMID:[A case of left ventricular-right atrial communication complicated with aortic regurgitation caused by active infective endocarditis]. 783 20

Forty three year-old male who had cough and easy fatigability since three weeks prior to admission was diagnosed to have acute pulmonary edema with severe mitral regurgitation caused by active infective endocarditis. Transesophageal echocardiograms under the endotracheal intubation for controlled respiration suggested rupture of the posterior papillary muscle of the mitral valve and the emergency surgical treatment was performed. Intraoperatively the total rupture of the posterior papillary muscle was confirmed and mitral valve replacement was carried out with a SJM prosthetic valve. Histological examination of the ruptured papillary muscle revealed hemorrhage, muscle necrosis and small cell infiltration suggesting the presence of active inflammation with bacteria on it. Staphylococcus epidermidis was demonstrated by the bacteriological studies of the ruptured papillary muscle.
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PMID:[Successful surgical treatment in a case of complete rupture of the posterior papillary muscle of the mitral valve caused by infective endocarditis]. 808 83

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

Recurrence of cardiac myxoma after surgery is an uncommon situation, particularly if a wide excision of the tissue under the tumour has been done. The authors report a case of a 54-year-old male presenting with a left atrial myxoma near the mitral valve, which had to be replaced by a mechanical prosthetic valve during the removal of the tumour. One year later, he was admitted to hospital with persistent fever, weight loss, and congestive heart failure. After a positive hemoculture, intravenous antibiotherapy was initiated, and twice modified because of relapsing fever. Six weeks later, he was transferred to our institution, after an episode of severe acute pulmonary edema. 2D-Doppler echocardiography suggested the possibility of prosthesis dysfunction, revealing a transprothetic diastolic flow with a high peak velocity and moderately elevated pressure half-time. No intra-atrial masses were visualized. Computed tomography was also inconclusive, because of multiple artifacts produced by the prosthesis. These results led to the performance of a cardiac catheterization with contrast ventriculography, which revealed the presence of a transprothetic gradient, and mild mitral regurgitation. The patient was submitted to cardiac surgery, which revealed a recurrent pedunculated left atrial myxoma, with mechanical obstruction of the mitral prosthetic valve. No signs of endocarditis were found. Recurrent cardiac myxomas are reviewed and discussed, as well as the specific problems of the present case, namely the presence of a mechanical prosthetic mitral valve and the initial hemoculture results, with consequent diagnostic delay.
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PMID:[The recurrence of an atrial myxoma in a patient with a mechanical mitral prosthesis--apropos a case]. 832 83

Brucella endocarditis was diagnosed in a 21-year-old itinerant farm worker hospitalized for acute pulmonary edema. History taking revealed cough, fever and sweating one month earlier which had been treated with antibiotics. At admission, echography showed lesions on the aortic valve and hemocultures identified Brucella meltensis. On day 7 of specific treatment with doxycycline (200 mg/day) and rifamycine (1200 mg/day), and despite digitalics and diuretics, left ventricular failure rapidly worsened, leading to cardiac arrest and death before emergency surgery could be performed. Autopsy showed occlusive vegetations on the aortic valves facing the right coronary ostium, deep ulceration of the valsava sinus with abscess formation and fibrino-hemorragic pericarditis involving both the anterior and posterior walls of the epicardium. Gram negative germs were evidenced in the abscess alone. This case emphasizes the potentially rapid destructive effect of Brucella melitensis and confirms that surgery is the safest therapeutic alternative for aortic valve localizations. Surgery should be performed without delay.
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PMID:[Brucella pancarditis with fatal outcome]. 866 92

The authors report two cases of pulmonary valve endocarditis which required emergency surgical treatment. A 74 year old patient with trivalvular endocarditis (pulmonary, aortic, mitral), due to Sptreptococcus D bovis, developed cardiogenic shock with acute pulmonary oedema and underwent double aortic and pulmonary valve replacement with Carpentier-Edwards prostheses and simple resection of a mitral valve vegetation. Another 36 year old drug addict developed isolated pulmonary valve endocarditis due to Staphylococcus aureus infection complicated by pulmonary regurgitation with right ventricular failure and by septic pulmonary embolism with persistent sepsis: he underwent pulmonary valve replacement with a Bravo 300 bioprosthesis. The postoperative course was uncomplicated in both cases, with interruption of the infection and normalisation of the haemodynamic status. The insidious and severe nature of pulmonary valve endocarditis is demonstrated by these two cases, confirming previous reports which have underlined the poor prognosis of this condition. Surgery has been shown to be effective and well tolerated and should be integrated early in the therapeutic strategy, the results being all the better when an aggressive attitude is taken.
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PMID:[Pulmonary valve replacement for endocarditis. Apropos of 2 cases]. 876 8


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