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

Pathologic studies were done on 20 hearts of patients who had typical clinical signs and symptoms of Kawasaki disease. The cardiac lesions were classified according to the duration of illness at the time of death. Stage I (zero to nine days) was characterized by acute perivasculitis and vasculitis of the microvessels (arterioles, capillaries, and venules) and small arteries, and acute perivasculitis and endarteritis of the three major coronary arteries (MCAs). Pericarditis, myocarditis, inflammation of the atrioventricular conduction system, and endocarditis with valvulitis were also present. Stage II (12 to 25 days) was characterized by panvasculitis of the MCAs and aneurysm with thrombus in the stems. Myocarditis, coagulation necrosis, lesion of the conduction system, pericarditis, and endocarditis with valvulitis were also present. In stage III (28 to 31 days), granulation of the MCAs and disappearance of inflammation in the microvessels were noted. Patients in stage IV (40 days to 4 years) had scarring with severe stenosis in the MCAs. Fibrosis of the myocardium, coagulation necrosis, lesions of the conduction system, and endocardial fibroelastosis were also present. The features observed revealed Kawasaki disease to be acute and inflammatory. The angiitis begins in the microvessels and fibrinoid necrosis of the media is rare. The disease is one with a pathologic pattern previously unknown.
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PMID:Pathology of the heart in Kawasaki disease. 26 36

The results of pathomorphological and virological studies of experimental Coxsackie A 13 virus infection in BALB/C mice are described. Chronic myocarditis, endocarditis and valvulitis were observed in mice inoculated 10 to 12 hours after birth. The virus was revealed in the infected mice for 15-20 days only.
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PMID:[Heart lesions in mice with experimental infection caused by Coxsackie virus A13]. 95 98

From 1969 to 1974, 19 cases of Serratia marcescens endocarditis were observed in the San Francisco Bay Area. Seventeen patients were intravenous drug users, and Serratia caused 14% of all addict-associated endocarditis in San Francisco. Serratia strains were nonpigmented and had typical antibiotic sensitivities, except that 9 of the isolates exhibited colonial variation, with each variant having different antibiotic sensitivities. Aortic or mitral valves were involved in 13 patients, and heart failure developed in 9 of these. Twelve patients had embolic episodes to brain, iliofemoral arteries, or lung. Five of 6 patients with tricuspid valvulitis were cured by antibiotics either with (1) or without excision of the valve. All 12 patients with aortic or mitral valvulitis treated medically died; 11 had unremitting sepsis. Aortic valve replacement and antibiotics were effective in 1. Gentamicin combined with either carbenicillin or chloramphenicol was the most effective treatment regimen.
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PMID:Serratia marcescens endocarditis: a regional illness associated with intravenous drug abuse. 110 90

Tuberculous valvular endocarditis is exceptionally rare. It is usually manifest in the context of miliary tuberculosis, and in all but one case the diagnoses have been made at necropsy. Because of its rarity there is still uncertainty as to whether true tuberculous endocarditis exists as a clinical entity. This paper describes a case of miliary tuberculosis with aortic valvulitis that resolved on antituberculous therapy.
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PMID:Valvular tuberculous endocarditis: a case report and review of the literature. 212 24

From July 1981 to October 1988, 1597 native valves, 926 (58%) mitral and 671 (42%) aortic, were excised. The gross and histological features of all valves were studied using routine histochemical, immunohistochemical and electron microscopy techniques. As far as mitral valve is concerned the lesions were: stenosis 263 (28.6%), stenosis + incompetence 537 (57.8%) and incompetence 126 (13.6%). Our study was limited to the valves of patients undergoing mitral valve replacement because of pure incompetence. The pathological alterations of the valves were: floppy mitral valve (FMV) 59 (46.8%), rheumatic disease (RD) 50 (39.6%), infective endocarditis (IE) 13 (10.3%), papillary muscles ischemic disease (PMID) 4 (3.1%). In the FMV group the associated lesions were: aortic valve incompetence due to floppy aortic valve and noninflammatory aortic root disease (9-15.2%), tricuspid valve incompetence (4-7.8%) and atrial septal defect (7-13.7%). The commonest complication in this group was rupture of chordae tendineae requiring urgent surgery. In the RD group there was a high incidence of active rheumatism, valvulitis and papillary muscles myocarditis (37-74%) despite the laboratory data were within normal ranges. In the IE group there was an associated aortic endocarditis in 7 patients (53.8%). The FMV was the commonest cause of pure incompetence in patients who had mitral valve replacement. Rheumatic pure mitral incompetence was always associated in our experience to signs of active rheumatic disease.
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PMID:[Etiology and incidence of pure mitral insufficiency: a morphological study of 926 native valves]. 224 33

A 67-year-old man with grade 3 aortic valve regurgitation was found to have a quadricuspid aortic valve. The aortic valve consisted of 1 large, 2 intermediate and 1 small sized cusp. An accessory cusp located between the right and noncoronary cusps, and shaped like a hammock which sling by the fibrous strings originating from the both commissures to the aortic wall. Aortic valve replacement was successfully performed with a 23 mm St. Jude Medical prosthetic valve, and the patient is asymptomatic five months post-operatively. Histological examination of the resected cusps showed fibrous thickening and no rheumatic valvulitis or infective endocarditis.
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PMID:[A case of quadricuspid aortic valve with aortic regurgitation]. 238 29

A clinico-morphological observation of Wegener granulomatosis in a 29-year-old man is described. The disease started with the gastrointestinal disorders followed by lung and renal disturbances which dominated. Heart enlargement and systolic-diastolic noise in the Botkin point were found. Infectious endocarditis with a complex aortal defect were diagnosed. The patient died 6 months later. The autopsy revealed a necrotizing lung granulomatosis, disseminated vasculitis, renal and spleen infarcts. Vasculitis with granulomatosis, destructive changes in the intima were found in the supravalvular part of the aorta and at the base of the aortic valve as well as severe fibrinous valvulitis.
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PMID:[A case of Wegener's granulomatosis with involvement of the aortic valve]. 262 66

In this review, the cardiac lesions which develop in association with the various collagen-vascular diseases are described. In rheumatoid arthritis, the most frequent lesions are: fibrous obliterative pericarditis, with pericardial deposits of calcium, fibrin, cholesterol, and rheumatoid granulomas; granulomatous or nonspecific myocarditis; valvulitis, vasculitis, and amyloid deposits. In ankylosing spondylitis, the lesions involve mainly the valves (aortic and mitral valves) and the aorta. In systemic lupus erythematosus, the predominant cardiovascular lesions are: pericarditis, Libman-Sacks endocarditis, nonspecific myocarditis, vasculitis with fibrinoid necrosis, and acceleration of atherosclerosis. In scleroderma, the main cardiac lesion is fibrosis with only scanty inflammatory cells; pericarditis and nonbacterial thrombotic endocarditis also occur. In dermatomyositis/polymyositis, fibrous or fibrinous pericarditis can occur, as well as myocarditis with infiltrates of lymphocytes and plasma cells and with degeneration and necrosis of myocytes; valvulitis is uncommon except when the disease is related to mucinous adenocarcinoma. In polyarteritis nodosa, various stages of necrotizing vasculitis involve all layers of the arterial walls; foci of myocardial necrosis of various sizes can occur in association with these lesions; cardiac hypertrophy related to hypertension and pericarditis related to uremia, may also be found. In Wegener's granulomatosis, pericarditis, inflammatory infiltrates, necrotizing granulomas, and vasculitis have been observed in the heart.
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PMID:Cardiovascular lesions in collagen-vascular diseases. 391 76

The pathology and clinical features of 258 cases of mitral ring calcification were reviewed. The overall incidence in patients over 50 years of age was 8.5%; it was more than twice as high in women (11.5%) as in men (4.5%) and rose sharply with age. Cardiac failure and systolic murmurs were each noted in over half the patients. Hypertension was slightly commoner than in age- and sex-matched groups without ring calcification, although the difference was not statistically significant. Small nodules of calcification were more frequent in men and heavy deposits in women. Distortion and atrial displacement of the posterior mitral cusp was present in 26% of the hearts with early ring calcification, in 56% of the hearts with moderate, and in almost all hearts with marked changes. Systolic murmurs had been heard in 73% of these cases. ;Caseation' of the calcified ring was seen in seven hearts and haemorrhagic valvulitis in three. Calcium had ulcerated through the cusp in 12 cases, with thrombotic and/or bacterial endocarditis in five. Aortic valve calcification was present in 36% of men and was quantitatively related to the severity of mitral ring calcification. In women the incidence was 30% and there was no corresponding quantitative relationship. Microscopy showed nonspecific chronic inflammatory changes adjacent to calcium in about half the cases in both sexes, with foreign body type giant cells in 6%. Similar inflammatory changes in the valve cusp were almost twice as common in women as in men. There was no evidence that previous endocarditis was responsible for mitral ring calcification, neither did parity influence its incidence. Severe coronary atherosclerosis was unrelated but severe aortic atherosclerosis was commoner in patients with calcified mitral rings. The difference, in women, was statistically significant. The higher incidence of severe degrees of ring calcification, complications, and valvular inflammation in women suggests a sex-determined difference in tissue response in the mitral area. Possible provoking factors apply to both sexes and both left side valves, and such a difference would account for the relative frequency and sex incidence of mitral ring calcification.
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PMID:Pathological and clinical study of calcification of the mitral valve ring. 543 Apr 24

Pitfalls in the clinical diagnosis of the aetiology of acquired tricuspid incompetence in children were exemplified in five patients. In three of them acute staphylococcal endocarditis, the cause of the valve defect, was obscured during life by co-existing sickle cell haemoglobinopathy, acute leukaemia and rheumatic mitral valvulitis, respectively. The fourth and fifth patients had clinical features suggestive of right ventricular endomyocardial fibrosis but necropsy revealed that the tricuspid incompetence was caused by dilated cardiomyopathy and constrictive pericarditis respectively. This series illustrates the need to suspect bacterial endocarditis if a child presents with signs of infection and valvular incompetence, and also dispels the widespread belief that pericardial constriction does not cause tricuspid incompetence.
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PMID:Acquired tricuspid incompetence in children: pitfalls in the clinical diagnosis of its aetiology. 619 11


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