Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coronary embolism is an uncommon cause of myocardial infarction which should be considered especially in patients with associated conditions like atrial fibrillation, intracardiac prosthesis or infective endocarditis. We present the case of a 64-year-old man with lone paroxysmal AF who sustained an acute anterior wall infarction due to an embolism in the LAD. The patient was being treated with tamoxifen for benign gynaecomastia. The case illustrates some therapeutic problems of embolic myocardial infarction. Rescue PTCA after unsuccessful thrombolysis first resulted in distal embolization in diagonal branches with the need for aggressive anticoagulation. While the final angiographic result was satisfactory, the patient died of an intracranial hemorrhage. We present a short overview of the therapeutic options of coronary embolism and discuss the effect of the selective estrogen receptor modulator tamoxifen on arterial and venous thromboembolic disease which is suggestive of a pathogenic role.
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PMID:A case of coronary embolism in a patient with paroxysmal atrial fibrillation receiving tamoxifen. 1729 10

A coronary artery fistula is a link between one or more coronary arteries with another heart cavity or a segment of systemic or pulmonary circulation. Arterial blood from a coronary vessel enters another segment via myocardial capillary bed. These are very rare anomalies which constitute approximately 0.2 - 0.4% of all congenital heart defects. Still, they are clinically significant if they are of medium or large size and are manifested with a series of clinical symptoms such as angina pectoris, arrhythmias, myocardial infarction, endocarditis, progressive dilatation, heart failure and cardiomyopathy, pulmonary hypertension, thrombosis of the fistula and formation of aneurysms with possible ruptures. We present six patients with a coronary arterial fistula, their history, diagnostic procedures and outcomes. Therapeutic closure of coronary artery fistulas is recommended in all symptomatic, but also in asymptomatic patients, if there are significant roentgenographic, electrocardiographic and other abnormalities. In recent times transcatheter closure of coronary fistulas has become a possible alternative to surgery and is becoming increasingly used thanks to improved diagnostic possibilities and technology. If possible, interventional closure of fistulas is precisely the method preferred in pediatric patients. The choice of method depends on the anatomy of the fistula, presence or absence of additional defects, and on the experience of an interventional cardiologist or a heart surgeon. If performed well, the effects of both methods are good. This paper presents two children with a fistula between the right coronary artery and the right ventricle (RV), one child with a fistula between LAD and RV, one child with a fistula between the main tree of the left coronary artery (LCA) and RV, one child with a fistula between LCA and the right ventricular outflow tract (RVOT), and one child with a fistula between LCA and the right atrium (RA). The last one (LCA-RA) is not described in the latest classification of anomalies of coronary blood vessels in children based on MSCT coronarography, so we consider our presentation to be a contribution to the new classification. Along with the descriptions of fistulas and presentations of interventional and cardiosurgical interventions, we are also presenting a rare case of spontaneous closing of the fistula within the first six months and of a reopening of the fistula between the right coronary artery and the right ventricle after six years.
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PMID:[Congenital coronary artery fistulas: clinical and therapeutic consideration]. 2563 71

Acute myocardial infarction (MI) in the setting of infective endocarditis (IE) of mechanical cardiac valve is a rare phenomenon. The most challenging aspect is the recognition between septic embolus versus thromboembolism from prosthesis in the setting of sub-therapeutic INR especially when the coronary vasculature is normal and etiology is not clear. We are presenting a case of 56-year-old patient who developed ST elevation MI during treatment of IE of mechanical aortic valve. Cardiac catheterization showed a very subtle blockade at most distal end of LAD therefore percutaneous coronary intervention (PCI) could not be carried out. Given the lack of clear etiology between septic embolus versus prosthesis associated thromboembolism, we opted for a successful conservative approach.
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PMID:Thrombus or vegetation: A mystery causing ST elevation myocardial infarction with infective endocarditis of mechanical aortic valve. 2828 87

To evaluate the efficacy and safety of a new domestic dacron patch in the surgical treatment of congenital heart disease (CHD) with infective endocarditis (IE), a clinical controlled trial is conducted. 48 patients with CHD complicated with IE are selected and randomly divided into two groups. 26 patients in the experimental group are treated with a new domestic dacron patch, while 22 patients in the control group are treated with an imported cardiac polyester patch. By echocardiography, collecting chest X-ray, echocardiography and laboratory examination before and after operation, the residual shunt, cardiac function, liver function, renal function, coagulation function and other related indicators are observed after operation in the two groups, and the therapeutic effect and safety of the new dacron patch are evaluated. The results showed that there is no significant difference in C/T (cardiothoracic ratio), LAD (Left atrial diameter), LVSD (left ventricular end systolic diameter) and LVDD (left ventricular end diastolic diameter) between the two groups before operation, before discharge and 1, 3 and 6 months after discharge (P>0.05). The C/T, LAD and LVDD of the two groups decrease 6 months after operation, and the size of atrioventricle decreases significantly. There is a decreasing trend in the experimental group compared with the control group, but there is no significant difference (P>0.05). There are no significant differences in cardiac function classification, echocardiography, electrocardiogram, patch performance evaluation and blood compatibility between the two groups before operation and 6 months after discharge. CONCLUSION: The new domestic dacron patch has good clinical efficacy and safety.
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PMID:Efficacy and safety of dacron patch in surgical treatment of congenital disease by echocardiography. 3152 40

Ankylosing spondyloarthritis (AS) is a chronic inflammatory rheumatic disease, strongly related to human leukocyte antigen (HLA)-B27. Cardiac involvement in AS manifests in 2 to 10% of patients as aortic insufficiency, aortitis, mitral valve fibrosis, or disturbance in the conduction of the heart. In this article, we present a case of a 49-year-old male patient with AS, who was referred to our medical institution for elective aortic valve surgery because of severe aortic regurgitation. The histological findings revealed fibrosing endocarditis of aortic valve and nonspecific aortitis of aortic root. Late postoperatively, we observed exacerbation of AS and narrowing of the main left coronary artery (LAD). Our case highlights the importance of proper treatment of AS before and after cardiac surgery. Furthermore, in this case, we suspect association between cardiopulmonary bypass, activity of AS, and coronary artery disease.
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PMID:Ankylosing Spondyloarthritis Resulting Severe Aortic Insufficiency and Aortitis: Exacerbation of Ankylosing Spondyloarthritis and Stenosis of the Main Left Coronary Artery after Mechanical Aortic Valve Implantation with Cardiopulmonary Bypass. 3198 47