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

The data were reviewed of 42 patients who had valvulotomy for severe aortic valve stenosis before 1968. All were over age 2 years (mean age 11.3 years). The mean time of follow-up after surgery was 10.6 years (range 6 to 16.3 years). No patient died at operation. Two late deaths were from endocarditis with aortic regurgitation, and one patient with severe arotic regurgitation died suddenly; three patients had valve replacement for aortic regurgitation and one required repeat valvulotomy. Five patients could not be traced. Major symptoms were alleviated in all patients. Left ventricular pressures were obtained in 15 patients before and after operation; the mean gradient averaged 100 mm Hg before and 43 mm Hg after operation. No patient had significant aortic regurgitation before operation. Twelve had moderate to severe regurgitation after operation. The incidence of late valve calcification at a mean time of 10.6 years after operation was small, and restenosis was uncommon. Because moderate or severe incompetence can be produced and stenosis is often incompletely relieved, the operation is palliative, but the low morbidity and mortality rates suggest that it is an effective procedure if stenosis is severe and life-threatening.
Am J Cardiol 1976 Aug
PMID:Long-term follow-up of valvulotomy for congenital aortic stenosis. 13 6

A 36-yr-old woman and a 46-yr-old man had infective endocarditis of the mitral valve. Examination by 2-dimensional dynamic echocardiography demonstrated large mobile vegetations in both patients, and the display pointed to an ominous risk of embolism. Heart surgery with valve replacement was performed, the main indication being prophylaxis against embolism; the operative findings seemed to justify the assumption of imminent risk of embolism. It is suggested that the display of dynamic morphology of valvular vegetations by 2-dimensional echocardiography can be useful in identifying a subset of patients at high risk of embolism during infective endocarditis. However, more experience is needed before definite conclusions can be drawn regarding the role of early operation as prophylaxis against impending embolism.
Eur J Cardiol 1979 Nov
PMID:Mitral valve replacement in infective endocarditis as prophylaxis against embolism. Identification of patients at risk by 2-dimensional echocardiography. 31 76

William Heberden (1710--1801), in 1768, described angina pectoris, the classic symptom of ischemic heart disease, 150 years after the discovery of the coronary circulation by William Harvey (1578-1657). Another 110 years had elapsed before the first antemortem diagnosis (confirmed at autopsy) of coronary thrombosis was reported by Adam Hammer in 1878. The patient was a 34 year old man who died some 19 hours after a sudden collapse. Although the patient's clinical features were atypical (such as the absence of angina and the presence of complete heart block) and the autopsy showed vegetative aortic endocarditis that appeared to be causally related to the thrombotic coronary occlusion, Hammer's astute and carefully reasoned bedside diagnosis was history-making and deserves to be so recognized.
Am J Cardiol 1978 Nov
PMID:Centenary of the first correct antemortem diagnosis of coronary thrombosis by Adam Hammer (1818--1878): English translation of the original report. 36 Aug 11

Mitral valve replacement is considered when there is severe mitral stenosis, severe mitral insufficiency or a combination of the two. Ordinarily, surgical replacement is considered only for patients who are in functional classes III or IV and do not respond to medical management. Patients with symptomatic mitral stenosis should be treated with mitral commissurotomy whenever possible. Patients selected for commissurotomy should have a pliable valve, no other major valve dysfunction, sinus rhythm, no systemic embolism and good left ventricular function. Early operation is not ordinarily required. Mitral insufficiency may require mitral valve replacement in six rather common settings: rheumatic disease, rupture of mitral chordae tendineae, postinfarction rupture of a papillary muscle, intractable infective endocarditis, floppy mitral valve and malfunction of a prosthetic valve. Rupture of mitral chordae tendineae can usually be recognized from the history, physical examination, echocardiogram and angiocardiogram. Severe left ventricular papillary muscle dysfunction is usually due to cardiac infarction, and occurs within the first 9 days of infarction. When only a papillary muscle tip is ruptured the patient may survive long enough for a mitral valve replacement. In infective endocarditis, operation is more often needed because of congestive heart failure than because of refractory infection. Evidence of mitral stenosis or insufficiency in a patient with a previously implanted prosthetic valve usually indicates an urgent need for study and early operation. Uncommon causes of mitral incompetence that may require valve replacement are endocardial fibroelastosis, Marfan's syndrome, calcified mitral anulus, osteogenesis imperfecta, methysergide-induced heart disease and carcinoid heart disease.
Am J Cardiol 1979 Jul
PMID:Indications for surgical replacement of the mitral valve. With particular reference to common and uncommon causes of mitral regurgitation. 37 33

The clinical utility of two dimensional echocardiography in assessing bioprosthetic and left ventricular function was studied in 40 consecutive patients 1 week to 60 months after valve replacement surgery. These patients were referred to obtain normal baseline studies as well as to evaluate complications:suspected endocarditis, embolic phenomena and congestive heart failure of unknown cause. Independent M mode echocardiograms were also obtained in each patient. Confirmation of ultrasonic studies was by cardiac catheterization with angiography, surgery and pathologic study in 10 patients; cardiac catheterization with angiography alone in 7 patients; surgery and pathologic study in 3 patients; autopsy in 3 patients; blood cultures to confirm or exclude endocarditis in 10 patients; and confirmation on clinical grounds in 7 patients. Technically adequate two dimensional studies were recorded in 39 of 40 subjects. Two dimensional echocardiography accurately assessed 15 of 16 patients with an abnormal bioprosthetic valve and a normal left ventricle (1 of 16 patients had a false positive two dimensional echocardiogram); 8 of 8 patients suspected to have prosthetic valve or left ventricular dysfunction but who were normal; 7 of 7 patients with a normal prosthesis and an abnormal left ventricle; the one patient with an abnormal valve and left ventricle; and 7 of 7 clinically normal patients who were referred for baseline studies. In summary, the two-dimensional echocardiogram demonstrated a 97 percent diagnostic accuracy rate which was significantly greater than the 67 percent (P less than 0.001) for M mode echocardiography in the same group of patients. It is concluded that two dimensional echocardiography has excellent diagnostic accuracy in assessing bioprosthetic and left ventricular function and is superior to M mode echocardiography in evaluating patients after such valve replacement.
Am J Cardiol 1979 Mar
PMID:Two dimensional echocardiographic assessment of patients with bioprosthetic valves. 42 Jan 2

M-mode and two-dimensional echocardiographic evaluation of infectious endocarditis and its complications was reviewed. In 21 consecutive patients with clinical endocarditis, 22 valves were involved (12 aortic, 5 mitral and 5 tricuspid). M-mode echocardiography detected vegetations in 10 patients (four aortic, two mitral and four tricuspid) and detected complications of endocarditis in 2 patients (one aortic root abscess and one flail aortic cusp). Two-dimensional echocardiography detected vegetations in 9 patients (four aortic, one mitral and four tricuspid) and detected complications in ten patients (five flail aortic cusps, one aortic root abscess, one sinus on Valsalva aneurysm, two flail mitral leaflets and one flail tricuspid valve). Thus, although M-mode and two-dimensional echocardiography had a similar ability to detect actual vegetations, two-dimensional echocardiography was superior to M-mode echocardiography in diagnosing complications of the destructive process.
Am J Cardiol 1979 Apr
PMID:Comparison of two-dimensional and M-mode echocardiography in the evaluation of patients with infective endocarditis. 42 9

A 19 year old woman presented with chest pain after a dental extraction for a dentoalveolar abscess. Electrocardiographic and serum isoenzyme changes were consistent with acute anterior myocardial infarction. At autopsy bacteria were demonstrated, within the myocardium in the absence of a myocardial abscess or endocarditis. This case illustrates the occurrence of isolated acute bacterial myocarditis after a dental extraction.
Am J Cardiol 1979 Jun
PMID:Fatal acute bacterial myocarditis after dentoalveolar abscess. 44 82

59 patients with suspected infective endocarditis on a natural valve were studied by M-Mode echocardiography to determine the specificity of the ultrasonic technique in detecting valvular vegetations. All echocardiograms were read independently by two observers who were unaware of the final diagnosis. Among 40 patients who later proved not to have infective endocarditis, two (5%) were diagnosed by echocardiography as having either possible or probably vegetation by at least one observer. Both patients with a false positive diagnosis of vegetation had pre-existing valvular pathology, the presence of which greatly complicated the interpretation of the echocardiogram. Inter-observer disagreement occurred in 5 of the 59 studies (8.5%). The results of this study suggest that caution should be exerted in the echocardiographic diagnosis of vegetation in patients with pre-existing valvular pathology.
Eur J Cardiol 1979 Oct
PMID:Echocardiography in infective endocarditis. Lack of specificity in patients with valvular pathology. 49 83

A case of staphylococcus epidermidis endocarditis associated with a right atrial thrombosis around a pacemaker electrode is presented. Stuce the antibiotic therapy had proved uneffective, the electrode had to be removed with cardiopulmonary bypass; the infection was subsequently eliminated. When a foreign body cannot be removed by closed techniques, open heart surgery with cardiopulmonary bypass may be necessary.
G Ital Cardiol 1979
PMID:[Removal of an endocavitary electrode with cardiopulmonary bypass for septicemia associated with right atrial thrombosis. Report of a case (author's transl)]. 54 3

Necropsy findings are described in eight Newfoundland dogs from the same colony with discrete subaortic stenosis. Infective endocarditis involving the aortic valve occurred in four dogs and in each it proved fatal. Damage to the aortic valve cusps by the jet of blood ejected through the discretely narrowed left ventricular outflow tract predisposes to the development of infective endocarditis in both dogs and human beings with discrete subaortic stenosis. Severe abnormality of the intramural coronary arteries in the ventricular septum, which also occurs in patients with hypertrophic cardiomyopathy, was present in all eight dogs. Myocardial fiber disorganization and asymmetric septal hypertrophy, two other findings observed in patients with hypertrophic cardiomyopathy, were absent in each of the eight Newfoundland dogs with discrete subaortic stenosis.
Am J Cardiol 1978 Apr
PMID:Discrete subaortic stenosis in Newfoundland dogs: association of infective endocarditis. 56 82


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