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

The pathologic study of the cardiac lesions in 25 persons who died of AIDS were studied from autopsies. Most of these patients were intravenous drug abusers (14 cases). Heart failure was symptomatic and lead to death in 4 cases. This study showed histological abnormalities in 76% of the cases. We observed 12 myocarditis. In 6 cases, pathogenes were found: Toxoplasma gondii (2), Cryptococcus neoformans (2), Candida (1), Aspergillus (1). A lymphocytic myocarditis was observed in 6 hearts. By immunohistochemical technique, we could distinguish 2 toxoplasmic myocarditis, and in 4 cases, solitary cysts in the myocardium without inflammation. The remaining lesions comprised respectively: 3 lymphocytic pericarditis, 2 marastic endocarditis and 1 dilated myocardiopathy.
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PMID:[Cardiac lesions in acquired immunodeficiency syndrome (AIDS). Apropos of an autopsy series of 25 cases]. 225 24

Seven cases of infective endocarditis (IE) in patients with hypertrophic obstructive cardiomyopathy (HOCM) are presented in this report. The previous literature is critically reviewed, and the following points are discussed: (a) IE complicates HOCM in 5-9% of cases; (b) anatomical and haemodynamic alterations of HOCM cause microtraumas on heart valves and the endocardium; the resulting endocardial lesions represent sites for bacterial seeding as well as other congenital or acquired heart disease; (c) prognosis is worse in patients with IE associated with HOCM than in patients with IE alone or associated with congenital heart disease; (d) the most frequently isolated organisms are saprophytes; (e) most patients were exposed to bacteraemias before the onset of IE.
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PMID:Hypertrophic obstructive cardiomyopathy and infective endocarditis: a report of seven cases and a review of the literature. 228 24

This case report describes a patient with an uncommon type of mitral incompetence caused by a perivalvular communication between the left ventricle (LV) and the left atrium (LA) masked by a considerable fibrotic subvalvular aortic stenosis, endocarditis and congestive heart failure (CHF). A 64 year old farmer with a history of a systolic murmur since childhood complaining of increasing fatigue and dyspnoea, temperature over 39 degrees C, and signs of CHF was admitted and transferred to a cardiological unit. Invasive examination and continuing clinical deterioration caused urgent transfer for surgery under suspicion of a decompensated hypertrophic obstructive cardiomyopathy. Clinical investigation revealed a decompensated subvalvular aortic stenosis and a mild mitral insufficiency. At surgery the advanced fibrotic subvalvular stenosis was resected. After coming off bypass severe mitral insufficiency was detected by intraoperative analysis of the simultaneous intracavitary-pressure tracings. A midsystolic maximum of a high V-wave of the LA-pressure tracing was suggestive of an unusual reason of the mitral insufficiency. Reexploration indicated a perivalvular broad communication from the LA groove to the LV with an otherwise normal mitral valve. The communication was closed using buttressed mattress-sutures. This uncommon type of mitral incompetence via a perivalvular LA-LV communication was probably caused by endocarditis and an intramyocardial abscess in the LA-wall which subendocardially led to LV-LA communication.
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PMID:Uncommon type of mitral insufficiency caused by perivalvular communication between left ventricle and left atrium. 230 25

The evolution of 60 cases of hypertrophic cardiomyopathy over a mean period of 6.3 years is described. The cases were separated according to echo-cardiographic findings into 4 categories: obstructive cardiomyopathy (29 cases), asymmetrical septal hypertrophy (22 cases), diffuse cardiomyopathy (6 cases) and apical cardiomyopathy (3 cases). A number of complications occurred during the follow-up, consisting of cardiac failure (20 cases), embolic accident (9 cases), aortic endocarditis (1 case) and arrhythmia (32 cases including 12 cases of supraventricular arrhythmia and 20 cases of ventricular arrhythmia). Five patients died suddenly. These data are compared with those obtained from the literature in an attempt to determine the main prognostic factors in hypertrophic cardiomyopathy.
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PMID:[Hypertrophic myocardiopathy. Course and prognosis. 60 cases]. 293 68

The indications for endomyocardial biopsy were evaluated from 116 consecutive cases. The diagnostic value of this invasive but well tolerated procedure was in agreement with data from the literature. An accurate diagnosis, unforseeable in 8% of the patients, was established in 12%. The diagnosis of apparently primary myocardiopathy with ventricular dilatation was confirmed in 45 out of 59 cases; there were 3 cases of myocarditis, 3 cases of restrictive cardiopathy (haemochromatosis, fibroplastic endocarditis) and 1 case of hypertrophic cardiopathy. No tissue abnormality was noted in 6 cases. An accurate diagnosis was obtained by biopsy in 1 case of "eosinophilic lung" without overt cardiac involvement. In malignant diseases treated with anthracyclines in doses reaching maximal theoretical total dosage (30 patients), severe tissue lesions were present in 10% of the cases, incipient haemochromatosis in 16.6% and subendocardial fibrosis in 3.3%. However, total doses of up to 600 mg/m2 could be administered to 90% of the patients. Myocardial lesions could be demonstrated in 1 of 2 patients with collagen disease. Endomyocardial biopsy therefore seems to be justified in myocardiopathies with ventricular dilatation, in some collagen diseases with a tendency to cardiac involvement and to monitor treatment with anthracyclines in total doses higher than the theoretical maximum dosage.
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PMID:[Right intraventricular biopsy. Indications and results. 116 cases]. 315 91

SLE is an inflammatory disease of unknown etiology with the potential of affecting virtually all organ systems. Cardiovascular involvement occurs frequently, although it is often mild enough not to cause clinical concern. Pericarditis is most commonly subclinical, noted only on echocardiogram. Pericardial fluid, which can accumulate rapidly enough to cause tamponade, is inflammatory in nature and can totally mimic infection. The occurrence of Libman-Sacks endocarditis, usually a pathological diagnosis of little clinical significance, has little if any correlation with the presence of audible murmurs. However, valve replacement is occasionally necessary secondary to sterile destruction. These valvular lesions can also embolize or become infected. The incidence of ischemic coronary disease is increased, both secondary to premature atherosclerosis and, rarely, coronary arteritis. Conduction disease and arrhythmias are infrequently reported in adult patients, but congenital CHB has been noted in children born to mothers who have circulating anti-Ro antibody. Evidence is accumulating that suggests there is a mild cardiomyopathy associated with SLE that may be due to thrombotic or inflammatory microvascular coronary disease. Acute clinical myocarditis also rarely occurs. Therapeutically, at present, a reasonable course would seem to be to limit all known possible contributing factors to premature coronary artery and myocardial disease (hypertension, hypercholesterolemia, smoking, steroid therapy, etc), to be vigilant about recognizing the rarer complications associated with SLE (infectious pericarditis and endocarditis, coronary arteritis, pericardial tamponade, clinical myocarditis), and to remember that these uncommon complications are indeed uncommon. The importance of vigorously treating systemic hypertension cannot be overstressed.
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PMID:Cardiovascular involvement in systemic lupus erythematosus. 333 84

The aetiological spectrum of angiographically verified pure isolated mitral regurgitation (MR) was studied in 48 consecutive adult patients (35 males). Severe MR was found in 35 patients (73%) and moderate MR in 13 patients (27%). Mitral valve prolapse (MVP) syndrome was found in 21 patients (44%). These were younger than the rest of the study population (55 +/- 13 vs. 62 +/- 6 years, p less than 0.05) and 15 (71%) of them were men. Endocarditis and chordal rupture occurred in 19% and 43% of the MVP patients. Sixteen patients (33%) had MR secondary to myocardial infarction while only three patients (6%) had MR of rheumatic aetiology. Bacterial endocarditis, hypertensive heart disease, hypertrophic obstructive cardiomyopathy and mitral annulus calcification were less frequently found. Mitral valve replacement was done in 20 (57%) of the patients with severe MR and MVP was the underlying disease in 15 (75%) of these patients. In conclusion, MVP is a frequent cause of pure isolated MR and of mitral valve replacement. In contrast to the preponderance of young females amongst MVP patients in population surveys, most of the MVP patients with MR in this study are middle-aged and elderly men.
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PMID:High occurrence of mitral valve prolapse in cardiac catheterization patients with pure isolated mitral regurgitation. 356 83

Some particular features of the cardiomyopathies (CM) observed in the tropics, especially in Africa, are emphasized in this study. Chronic parietal endocarditis is excluded from the CM group. The author presents facts that justify the linking of that affection to endocardial diseases. Myocardiopathies are acute ailments presenting with congestive lesions, reversible under etiological therapy. Anemic and beri-beri myocardiopathies are not unusual in the tropics and present a hyperkinetic syndrome before the stage of advanced cardiac insufficiency. Infectious or parasitic myocarditis seem frequent in the tropics. The author recalls the characteristics of the myocarditis in the human african trypanosomiasis which he opposes, particularly, to the american trypanosomiasis. The reality of bilharzial myocarditis is more debatable while bilharzial pulmonary hypertension is well documented. Chronic congestive CM presents a few specific characteristics in the tropics. The features, well described in temperate regions, are found in the tropics with a particularly unfortunate prognosis. Some alcoholic myocardiopathies have been observed. The rare occurrence of hypertrophic CM in the tropics results, seemingly, from a lack of exploratory means. The author studies briefly a recent series of 31 cases in Abidjan. Post-partum myocardiopathy seems to be the clinical appearance of a latent myocardial insufficiency of the normal post-partum in women presenting with associated risks factors (anemia, malnutrition, overwork, excessive sodium intake, etc.). An early diagnosis enables a cure only by resting, but it is sometimes necessary to associate a medical treatment. Death by embolism or the passing to chronicity are however possible. Drepanocytic CM is debatable and in many cases, seems hardly differentiated from anemic myocardiopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiomyopathies in tropical areas]. 377 21

Congestive heart failure in children is unusual as a presenting problem, and the nonspecific nature of the signs and symptoms in the pediatric population makes recognition difficult. Congenital heart disease is most common in the infant whereas older children most commonly develop congestive heart failure due to cardiomyopathy, myocarditis, electrolyte abnormalities, dysrhythmias, and, more rarely, endocarditis, and rheumatic carditis. Management focuses upon stabilization of the airway and ventilation while improving circulatory function. This is achieved by the use of inotropic agents, combined with attention to the volume and pressure overload, pulmonary problems, dysrhythmias, and ongoing follow-up.
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PMID:Congestive heart failure in children. 380 94

Drug-induced toxic changes in the myocardium have become an increasing problem. The effect of drugs on heart morphology may be acute or cumulative. In general, adverse drug reactions manifest themselves as myocarditis (toxic or hypersensitivity), cardiomyopathy with chamber dilatation, or restrictive disease. Drugs affecting embryologic development of the heart will not be discussed. Drugs causing myocarditis can be divided into: toxic myocarditis, e.g., cyclophosphamide. The morphologic changes are dose-related and have lesions of different ages, which include myocyte necrosis with hemorrhage and vasculitis. Fibrous endocarditis, e.g., methysergide. These reactions include thickening of the endocardium and sometimes the cardiac valves with fibrosis. Drugs causing hypersensitivity myocarditis, e.g., thiazide diuretics. In this case, the lesions are not dose-related, are the same age, and there is an eosinophilic infiltrate. Drugs causing cardiomyopathic-like changes of ventricular dilatation and failure, e.g., anthracyclines, particularly adriamycin. This group of drugs cause a gradual myofibrillar loss within cardiac myocytes and a sarcotubular dilatation which is characteristic. The damaged cells are replaced by fibrosis and ventricular failure ensues. With the rapid synthesis of new drugs, the problem of drug cardiotoxicity may be an ever-increasing problem. With the more widespread use of the endomyocardial biopsy, drug-induced heart disease can be documented and the effects of different methods of drug delivery and pharmacologic antagonists studied.
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PMID:Pharmacotoxic myocardial disease: an endomyocardial study. 387 Apr 88


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