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

Mitral valve prolapse is a common cardiac anomaly in which diagnosis is generally made by auscultation. In a typical case, a midsystolic click followed by a late systolic murmur is heard, although this pattern can vary. Selected pharmacologic agents (vasopressors and vasodilators) may be useful in diagnosis, and echocardiography can be helpful in cases without auscultatory signs. In the majority of cases, mitral valve prolapse is benign and no specific treatment is needed except reassurance and perhaps endocarditis prophylaxis. Patients with chest pain and symptomatic arrhythmias may benefit from propranolol, those with ventricular tachycardia should receive antiarrhythmic therapy, and those with abnormal resting ECGs or frequent ventricular premature beats should be further tested because of increased risk of sudden death or possibility of associated ischemic heart disease.
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PMID:Mitral valve prolapse: etiology, diagnosis, and management. 735 May 67

A young Protugese man, who had never travelled outside of Europe, was found to have a bacterial complication of a fibroplastic endocarditis. The onset was by a spontaneous chest pain, associated with a posterolatero-apical subepicardial ischemia and giant T waves in V3, V4, and calcification in the apex of the heart on radiography. Diagnosis was confirmed by intracardiac explorations: ventricular telediastolic pressures were increased; the lower border of the right ventricle was smooth, the left ventricle had a globular appearance with a smooth anterior border, the apex appearing to be completely excluded; coronarography was normal. Histological examination confirmed the presence of fibrosis. Anticoagulant treatment was started. Four months after the onset of the disease, a high fever, an apical systolic murmur, and nine positive blood cultures for a streptococcus mitis, suggested the development of a bacterial endocarditis, though no direct evidence was discovered. Improvement occurred after appropriate antibiotic therapy, and the anticoagulants were continued. Cardiac ultrasonography recordings were normal following this episode. This case-report is of two-fold interest: on the one hand it represents an early form of fibroplastic endocarditis, diagnosed by intracardiac exploration, and on the other hand it emphasizes the rare nature of bacterial complications of this affection. Authors differ in their evaluation of the frequency of chest pain, but their inaugural and isolated nature are rarely described. In most cases the presence of the disease is revealed by a progressive cardiac insufficiency. A very positive factor is the presence of calcifications, and the absence of an eosinophilia does not exclude the diagnosis. Electrical anomalies of the ischemic type are possible, but are rarely isolated findings, and the giant appearance of the T waves in this case is rather atypical. Bacterial complications are rare, and are only reported in 12 of the 218 cases described in the published literature. They are rarely diagnosed during the life of the patient (1 case only). The infection affects the cords, the valves, the thrombus, or the fibrosis itself.
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PMID:[Bacterial endocardiitis complicating fibroplastic endocarditis: a case report (author's transl)]. 746 43

The medical complications of cocaine abuse are being encountered by clinicians with increasing frequency. The cardiovascular manifestations of cocaine abuse include chest pain, myocardial ischemia and infarction, congestive heart failure, arrhythmias, infective endocarditis, and aortic dissection. The pathogenesis of these cardiovascular complications has not been fully elucidated but may be related to a combination of the sympathomimetic and membrane anaesthetic effects of cocaine. We present these concepts in a case discussion format.
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PMID:Cardiovascular manifestations of cocaine abuse. A case of recurrent dilated cardiomyopathy. 777 43

Bacterial endocarditis may present with acute chest pain due to coronary embolization and mimics acute myocardial infarction secondary to coronary atherosclerosis. We present the first case report of coronary embolization secondary to aortic valve endocarditis treated with standard doses of streptokinase and aspirin. The patient survived but sustained a large myocardial infarction and a major gastrointestinal bleed. Infective endocarditis should be considered in all patients presenting with acute chest pain. When myocardial infarction is due to coronary embolism from endocarditic valves standard thrombolysis regimes should be avoided.
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PMID:Acute coronary embolism complicating aortic valve endocarditis treated with streptokinase and aspirin. A case report. 808 59

For right-sided endocarditis associated with drug abuse a successful treatment by tricuspid valve replacement was reported. A 34-year-old female who had a history of intravenous drug use for 14 years was admitted with complaints of chest pain, fever and dyspnea. A large vegetation about 47 mm in size attached to the tricuspid valve with tricuspid regurgitation was detected by echocardiography. Methicillin-resistant staphylococcus aureus was isolated in a blood culture. Because infection was persistent and uncontrollable in spite of sensitive multiple antibiotic regimens, tricuspid valve replacement using a St. Jude Medical valve was successfully performed with excision of markedly destroyed leaflets and debridement of the infectious lesions. After surgery the patient has been free from infection for 3 years.
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PMID:[Tricuspid valve replacement for infective endocarditis in drug addict--a case report]. 852 70

Pericardial diseases, in the pediatric age group are rare, and are usually due to viral infection or collagen diseases. Since the advent of the antibiotic era, bacterial pericardial has rarely been reported, and the bacteria most commonly involved are Staphylococcus aureus, Streptococcus pneumoniae, Haemophylus influenzae and Neisseria meningitidis; other pyogenic agents have rarely been isolated in pericarditis. Gemella morbillorum, also known as Streptococcus morbillorum, is a Gram-positive pyogen, usually a saprophite agent of the human gastrointestinal tract, rarely associated with human infections such as arthritis, endocarditis and meningitidis; to our knowledge, it has never been isolated in pericarditis. We report a case of pyogenic pericarditis in an 11-year-old boy, suffering from substernal chest pain for about one year, in which the clinical symptoms, the presence of acute phase proteins, the large amount of fluid within the pericardial space (echocardiographically estimated to be approximately 18 mm), the lack of improvement in clinical conditions and in laboratory values after therapy (diuretics, broad spectrum antibiotics and steroids) led to the indication for a pericardial drainage with the isolation of Gemella morbillorum. Antimicrobial therapy was then modified according to in vitro susceptibility of the Gemella morbillorum, with a decisive contribution to the recovery of the patient, although long-term steroid therapy (5 months) was necessary because of one recurrence of pericardial effusion. This case report shows how Gemella morbillorum, usually a saprophit microorganism, can become pathogenic and also underlines the importance of a correct etiologic diagnosis of pericarditis resistent to classical antibiotic therapy.
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PMID:[Pericarditis caused by Gemella morbillorum. Description of a case]. 890 May 65

The mechanism of obstruction of the left ventricular outflow tract (LVOT) in hypertrophic obstructive cardiomyopathy (HOCM) is mainly due to dynamic systolic anterior motion (SAM) of the mitral valve. We report a case of HOCM with mitral regurgitation (MR) associated with complicated abnormalities of the mitral apparatus which contributed to a high pressure gradient through the LVOT. A small, 53-year-old woman was admitted for chest pain and palpitation. Examinations revealed asymmetric septal hypertrophy of the left ventricle, MR, SAM of the mitral valve and a high pressure gradient (108 mmHg) through the LVOT. Operative findings revealed an abnormally hypertrophied interventricular septum, an extensively thickened and enlarged anterior mitral leaflet (AML), malposition of the origin of the anterior papillary muscle arising closer to the aortic annulus than normal, and its direct insertion into the AML without any distinguishable chordae tendineae. The hypertrophied septum and the large and protruding AML appeared to obstruct the LVOT, resulting in a loss of subaortic clearance that was recovered after mitral valve replacement and myectomy. Pathology of the papillary muscle was characteristic of HOCM, showing disorganization and disarray of myocardial fibers, bizarre-shaped nuclei, and intercellular fibrosis, while those of the mitral leaflets negated both rheumatic changes and endocarditis.
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PMID:Hypertrophic obstructive cardiomyopathy with abnormalities of the mitral valve complex. 904 78

A 65-year-old man was hospitalized with persistent fever (up to 39 degrees C) of 3 weeks' duration 9 years after aortic valve replacement with a Hall-Kaster prosthesis. Multiple blood cultures demonstrated beta-Streptococcus. Transesophageal echocardiography disclosed mobile vegetations at the prosthetic valve with normal valve function. A diagnosis of late prosthetic valve endocarditis was made. Therapy was begun with penicillin G, cefazolin, and gentamycin. On the 20th hospital day, he suddenly developed severe chest pain. Electrocardiography was consistent with acute extensive anterior myocardial infarction. Coronary angiography revealed that the left anterior descending coronary artery was occluded in its proximal portion with an intraluminal filling defect, which was morphologically the same as the vegetation that had been demonstrated previously. Percutaneous transluminal coronary angioplasty was performed, and coronary artery perfusion was restored 4.5 hours after the onset of chest pain. Transesophageal echocardiography performed 2 days later revealed that the vegetation at the prosthetic valve level had nearly disappeared. This is the first reported case of coronary angioplasty in a patient with acute myocardial infarction caused by prosthetic valve endocarditis in Japan.
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PMID:[Successful coronary angioplasty in a patient with acute myocardial infarction caused by prosthetic valve endocarditis]. 906 26

A congenital coronary artery fistula is a rare anomaly characterized by a communication between one or more coronary arteries and a cardiac chamber, coronary vein, or less frequently, the pulmonary artery. The reported complications of this anomaly are congestive heart failure, infective endocarditis, and myocardial infarction. Although angina is not an infrequent complaint in the adult population with coronary to pulmonary artery fistulas, objective evidence of myocardial ischemia in the absence of concomitant atherosclerotic coronary artery disease has not been described. In this report, we describe an adult patient with chest pain and bicoronary to pulmonary artery fistulas in whom myocardial ischemia was documented by high-dose dobutamine stress echocardiography.
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PMID:Myocardial ischemia assessed by dobutamine stress echocardiography in a patient with bicoronary to pulmonary artery fistulas. 908 76

A case of successfully treated fungal tricuspid infective endocarditis with repeated pulmonary embolism is reported. A 60-year-old man had received along term intravenous hyperalimentation for the treatment of the complication after hepatopancreatoduodenectomy, associated with Candida sepsis. He was once discharged, successfully treated with antifungal agents. But he was readmitted to our hospital due to fever, cough and chest pain. Blood culture revealed Candida tropicalis. Pulmonary scintigraphy and angiography revealed multiple infarcts of the right lung, and echocardiography showed vegetation on the tricuspid valve. Because of exacerbation of shortness of breath, tricuspid valvuloplasty and thromboembolectomy in the pulmonary arteries was performed. Postoperative course was uneventful and he had a marked improvement of dyspnea after operation.
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PMID:[A case of successfully treated fungal tricuspid infective endocarditis with repeated pulmonary embolism]. 925 38


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