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

Bacterial endocarditis complicating idiopathic hypertrophic subaortic stenosis (IHSS) is uncommon but endocarditis may be the first clinical manifestation of IHSS. In this report of such a case, the aortic and the mitral valves were the sites of the bacterial infection. Many chordae tendineae to the mitral valve were ruptured from the extension of the infectious process. The endothelial lesions, which served as the seat for the bacterial infection on the anterior mitral leaflet, likely resulted from its abutting action against the septal prominence. Damage to the aortic valve leaflet may have resulted from abnormal valve motion caused by IHSS and created an environment conducive to endocarditis. This patient developed aortic insufficiency during the course of bacterial endocarditis, suggesting that the occasional association of aortic insufficiency in patients with IHSS may be secondary to healed endocarditis of the aortic valve.
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PMID:Bacterial endocarditis in idiopathic hypertrophic subaortic stenosis. 12 16

Three patients with endocarditis caused by Streptococcus mutans were seen during a six-month period. All had clinical features of subacute bacterial endocarditis, including fever, heart murmurs, and positive blood cultures. One had underlying aortic insufficiency and two had idiopathic hypertrophic subaortic stenosis. All patients were treated with parenteral antibiotics and were cured. Streptococcus mutans is a pleomorphic, microaerophilic organism that is associated with dental caries and plaque. Differentiation of S mutans from enterococcal endocarditis is important because the former condition can be treated for a shorter period of time with penicillin alone, without the addition of aminoglycoside antibiotics.
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PMID:Infective endocarditis caused by Streptococcus mutans. A complication of idiopathic hypertrophic subaortic stenosis. 56 72

In a 24-month period, 27 patients with idiopathic hypertrophic subaortic stenosis (IHSS), ages 65-80 years, were observed. Diagnoses were made by echocardiography (24 patients), cardiac catheterization (one patient), and both methods (two patients). The most common symptoms were angina (17 patients), dyspnea (13 patients), and syncope (11 patients). Two patients were asymptomatic, while another complained only of vague retrosternal chest discomfort with exertion. One asymptomatic patient had a completely normal physical examination, but electrocardiography (ECG) demonstrated a pattern of left ventricular hypertrophy. Another patient had an inconsistent apical holosystolic murmur. Two patients had alpha streptococcal endocarditis; neither was known to have pre-existing valvular disease. Fourteen patients had ECG criteria for left ventricular hypertrophy (LVH). Three patients were known to have associated aortic valve disease. The symptoms of IHSS may be nonspecific; asymptomatic patients with and without cardiac murmurs may be observed. Coexisting valvular disease, coronary artery disease, and bacterial endocarditis were documented. Patterns of myocardial infarction on ECG were not seen in these 27 patients.
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PMID:Idiopathic hypertrophic subaortic stenosis in the elderly. 56 40

In two patients infective endocarditis developed as the primary manifestation of idiopathic hypertrophic subaortic stenosis. Infected vegetations were present on the mitral and aortic valves. In addition, bacterial vegetations were observed on the septal endocardium at the site of contact between the mitral valve leaflet and the hypertrophic septum. Thus, chronic endocardial trauma, a common finding in idiopathic hypertrophic subaortic stenosis, may provide a fertile nidus for the development of bacterial vegetation.
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PMID:Mural vegetations at the site of endocardial trauma in infective endocarditis complicating idiopathic hypertrophic subaortic stenosis. 57 57

A patient with idiopathic hypertrophic subaortic stenosis suffered from five episodes of infective endocarditis of the mitral valve. At least two of these episodes were caused by Lactobacillus species, a microorganism known to be difficult to eradicate. Definitive cure was only achieved by surgical treatment.
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PMID:Recurrent infective endocarditis in idiopathic hypertrophic subaortic stenosis. 272 85

Our findings indicate that S. mutans endocarditis is capable of causing significant morbidity and mortality, as exemplified by the prolonged and complicated hospital course of our patients and the ultimate death of one of them. S. mutans endocarditis is probably underreported because most clinical laboratories do not speciate the viridans streptococci. Isolates of S. mutans should be tested for tolerance that would require the addition of an aminoglycoside to the penicillin regimen. Our experience agrees with the literature and indicates that S. mutans is primarily a pathogen in elderly patients with heart disease and may be associated with IHSS.
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PMID:Streptococcus mutans endocarditis: report of three cases and review of the literature. 335 Jun 87

The idiopathic hypertrophic subaortic stenosis (IHSS) is thought to be infrequently complicated by infective endocarditis. Because IHSS is a disorder of the myocardium and not endocardium is not generally considered to have increased risk of infective endocarditis. Some Authors found, however, that approximately 5% of patients with IHSS develop bacterial endocarditis, because hemodynamically IHSS is like to valvular diseases. Therefore the incidence of endocarditis in IHSS is the same of valvular diseases. The vegetations can be found on anterior mitral valve leaflet, aortic cusps and subaortic endocardium. Some patients have dental surgery prior to the onset of endocarditis and others are infected with oral streptococci. For these reasons prophylactic antibiotics should be administered to patients with IHSS undergoing dental manipulation and in other settings where the risk of developing bacteremia is high. We describe one case of IHSS complicated with streptococcus viridans endocarditis. Vegetations, determined with echocardiography, were present on anterior mitral valve leaflet, aortic right coronary cusp and interventricular septum. In a review of literature we are been able to find twenty-seven cases of IHSS complicated with endocarditis.
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PMID:[Infective endocarditis: a complication of idiopathic hypertrophic subaortic stenosis (author's transl)]. 719 53

A case is reported of aortic valve endocarditis in a 53 year-old female patient with idiopathic hypertrophic subaortic stenosis. Emphasis is made on the value of ultrasonography in the diagnosis of both conditions. Ecography has also prognostic interest when big vegetations are found. A comment is made on the need for early surgical replacement of the aortic valve when valvular insufficiency is present.
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PMID:[Infectious endocarditis in idiopathic hypertrophic subaortic stenosis. Report of a case (author's transl)]. 719 86

Three cases of infective endocarditis (IE) occurringg in patients with idiopathic hypertrophic subaortic stenosis (IHSS) are described. A review of the literature reveals the IE occurs in about 50 percent of the patients suffering from IHSS. It appears to complicate the natural history of the severe cases, at least as it appears from hemodynamic studies, being precipitated by the same factors and caused by the same infective organisms as in valvular heart disease. It has the same clinical picture and outcome, although the appearance of new murmurs was more common than in other types of heart disease complicated by IE, and indicated the same poor prognosis. The infection seems to involve both the aortic and the mitral valve, with equal frequency, and less commonly the ventricular outflow tract. The need for IE prophylaxis in cases of IHSS is stressed.
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PMID:Infectious endocarditis in idiopathic hypertrophic subaortic stenosis: report of three cases and review of the literature. 719 61

Cryopreserved aortic allografts were used for aortic valve replacement in 80 patients between 1986 and 1994 (infracoronary in 46 and complete root replacement in 34). Hospital mortality was 6.3% (5/80) with all deaths occurring in the infracoronary group. Three of five deaths were in patients with endocarditis and valve ring abscess. Left ventricular-aortic mean pressure gradients across the allograft valves were significantly lower for root replacement patients (mean, 9.0 +/- 6.9 mm Hg versus 18.1 +/- 8.7 mm Hg for infracoronary patients) (p = 0.0001). No patient having root allograft replacement had early echocardiographic aortic insufficiency greater than grade 1 versus 28% of those having infracoronary implantations. Late aortic insufficiency of grade 2 or greater was seen in 46% of patients having infracoronary implantation versus 17% of patients having root implantation. Nine patients had explantation of an aortic allograft (eight infracoronary and one root). Reasons for explantation were as follows: endocarditis (three infracoronary, one root), technical (three infracoronary), undiagnosed idiopathic hypertrophic subaortic stenosis (1 patient), and prolapsing infracoronary leaflet (1 patient). Actuarial freedom from grade 3 and 4 aortic insufficiency or explantation was 77% at 7 years for infracoronary implantations. We conclude that the infracoronary aortic allograft has an unacceptable frequency of late insufficiency and its use in this position should be abandoned. The substantial incidence of late endocarditis in the infracoronary (free-hand) aortic allograft was surprising.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Should the freehand allograft be abandoned as a reliable alternative for aortic valve replacement? 777 17


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