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

Over a period of 12 years, two cases of pulmonary arterial aneurysms were encountered in our autopsy data of 13 cases of congenital heart defects with right-sided infective endocarditis. Pulmonary arterial aneurysms are rare lesions and may be categorized as central or peripheral. Although early reports implicated tuberculosis as a major aetiologic factor, pulmonary arterial aneurysms are generally associated with congenital heart disease.
Int J Cardiol 1992 Jun
PMID:Pulmonary arterial aneurysms. 161 10

An unusual case of staphylococcal endocarditis with a vegetation attached to the left ventricular myocardium is described. No valvular vegetations are present. The diagnosis was made by transesophageal echocardiography. The patient had no chronic debilitating disease, nor was she immunosuppressed.
Can J Cardiol
PMID:Left ventricular mural bacterial endocarditis: diagnosis by transesophageal echocardiography. 161 13

The aim of this paper is to report for the first time the association between bronchiolo-alveolar carcinoma and acute myocardial infarction (AMI). Two patients suffering from this association were studied. A 59 year old male, diabetic, alcoholic and smoker was admitted because a diaphragmatic AMI. An interventricular septal defect and papillary posterior muscle rupture were confirmed at autopsy. A 0.8 cm diameter friable mass was found in the right lung superior lobe. The second case was a 69 year old male, smoker, who presented with a diaphragmatic and right ventricular posterior wall AMI. A round 1 cm diameter tumor was observed at the right lung superior lobe. It had a caseous aspect lying over a fibrous scar. Both cases had severe right coronary artery narrowings with recent occlusive thrombi. The cardiac valves were free of non-bacterial thrombotic endocarditis. Therefore the possibility of coronary embolization was discarded. As lung carcinomas produce vasospastic and thrombogenic mucins, these substances could have been responsible for the acute coronary thrombosis.
Arch Inst Cardiol Mex
PMID:[Acute myocardial infarction and bronchoalveolar carcinoma. Association or coincidence?]. 165 6

To detect potential cardiac abnormalities induced by intravenous heroin use, 68 persons without a previous episode of infective endocarditis were studied by Doppler echocardiography. A control group of 41 normal subjects was studied for comparison. The following measurements were considered: (1) diameter of heart chambers, (2) systolic left ventricular function, (3) morphologic valvular abnormalities, (4) presence of valve regurgitations, (5) Doppler indexes of diastolic function, and (6) estimation of pulmonary arterial resistances. Results showed no significant differences regarding the size of the heart chambers or systolic left ventricular function. A significantly higher incidence of valvular abnormalities (focal thickening or valve prolapse) was found in drug addicts (p = 0.0009) at the mitral and tricuspid valves, as was valvular regurgitation detected by Doppler (p = 0.04). Also, a significantly prolonged deceleration time of mitral and tricuspid early diastolic Doppler flow was found in the study group (p = 0.0001 and 0.027, respectively) although a different hemodynamic condition in the study group (pharmacologically reduced preload) precluded these findings to be attributable to an actual diastolic dysfunction. No differences were observed in pulmonary arterial resistances. It is concluded that mitral and tricuspid valve abnormalities can be detected by echocardiography in asymptomatic intravenous heroin users, whereas no apparent effects are observed in morphologic or functional parameters of cardiac structures other than the valves.
Am J Cardiol 1992 Jan 15
PMID:Findings on Doppler echocardiography in asymptomatic intravenous heroin users. 173 65

Certain clinical and morphologic findings are described in 11 patients with hypertrophic cardiomyopathy complicated by infective endocarditis that produced severe mitral or aortic valve regurgitation, or both, necessitating valve replacement. All 11 patients had changes in the operatively excised valve or valves characteristic of healed infective endocarditis. The infection involved only the mitral valve in seven patients, only the aortic valve in three patients and both valves in one patient. Study of the operatively excised mitral valves indicated that the healed vegetations were located most commonly on the left ventricular aspects of the anterior mitral leaflet, indicating that vegetation had formed at contact points of this leaflet with mural endocardium of the left ventricular outflow tract. In all 11 patients, the infective endocarditis either worsened preexisting valve regurgitation or initiated valve regurgitation and led to worsened signs and symptoms of cardiac dysfunction, necessitating valve replacement. Functional class improved in the nine patients who survived 7 to 101 months after valve replacement. Hypertrophic cardiomyopathy appears to be a factor predisposing to infective endocarditis. Patients with hypertrophic cardiomyopathy should receive prophylactic antibiotic therapy during procedures that predispose to infective endocarditis.
J Am Coll Cardiol 1992 Feb
PMID:Severe mitral or aortic valve regurgitation, or both, requiring valve replacement for infective endocarditis complicating hypertrophic cardiomyopathy. 173 66

Endovascular infections that involve the right side of the heart present their own unique etiologies, pathophysiologies, clinical manifestations, and therapeutic issues. The pathology of the vegetations of right-sided endocarditis is identical to that of left-sided endocarditis. These vegetations are irregular, friable masses of varying size the contain platelets, fibrin, RBCs, and microorganisms. These lesions serve as a nidus for deep-seated infection and produce sustained bacteremia. Right-sided endocarditis occurs in 5% to 10% of all cases of endocarditis. The most common predisposing factors are IV drug abuse and congenital heart disease. S. aureus is the most common pathogen. The clinical manifestations include fever, chills, rigor, dyspnea, pleuritic pain, productive cough, and hemoptysis. The cardiac manifestations can be notably absent early in the course of the disease, with only 20% of patients initially showing a significant murmur on physical examination. Peripheral embolic lesions can be seen. Echocardiography is helpful in identifying vegetations on the tricuspid valve in a significant proportion of patients. The chest radiograph is characteristic, showing features typical of multiple septic pulmonary emboli. The radiograph shows multiple, small, fuzzy, patchy, peripherally located densities that can change rapidly on serial films. Complications of right-sided endocarditis include pulmonary infarction, pulmonary abscess, progressive right-sided heart failure, and renal abnormalities. The treatment of right-sided endocarditis includes prolonged therapy, with high doses of IV bactericidal antibiotics. Four weeks of antibiotic therapy is generally required, but newer regimens using combination antibiotic therapy can be successful in sensitive strains of viridans group streptococci and S. aureus. Surgical resection of the tricuspid valve is recommended for organisms that do not respond to initial antibiotic therapy, fungal endocarditis, resistant relapsing organisms, or coexistent infection with S. aureus and P. aeruginosa. The prognosis of right-sided endocarditis is generally favorable when compared with left-sided endocarditis. The prognosis is especially favorable in IV drug abusers infected with S. aureus. Patients infected with fungal organisms, Pseudomonas or Serratia, have a worse prognosis. The presence of significant right-sided heart failure also imparts a worse prognosis.
Cardiol Clin 1992 Feb
PMID:Endovascular infections arising from right-sided heart structures. 173 55

Between 1987 and 1990, three patients with abscesses produced by Brucella endocarditis were admitted to the Department of Infectious Diseases, "Ospedali Riuniti", Bergamo, Italy. In each case, the diagnosis was based on a history of ingestion of milk products, positive Wright serology, positive blood and valvar culture, and echocardiography. Medical therapy alone was not found to be effective in treatment, all patients requiring surgical intervention. One case required urgent surgical treatment and underwent three further operations up to the final implantation of a valved tube. According to our experience, Brucella endocarditis is a rare but serious disease which requires a combination of medical and surgical therapy.
Int J Cardiol 1991 Nov
PMID:Brucella endocarditis. 174 97

A case of endocarditis of the aortic valve due to Streptococcus agalactiae is described in which the patient presented with a myositis sparing the myocardium. The patient required emergency replacement of the valve, and made a good recovery.
Int J Cardiol 1991 Nov
PMID:Endocarditis due to Streptococcus agalactiae presenting with myositis. 174 99

This study was designed to determine the clinical status, cause of death, and effects of pulmonary vascular disease and conduction abnormalities 30 to 35 years after surgery in 296 consecutive surviving patients of closure of ventricular septal defect. Of the 296 patients, current status was determined by contact with patient and physician in 290 cases, with 6 (2%) lost to follow-up (7,912 patient years are included). Cardiac catheterization after surgery in 168 patients showed complete closure of the defect in 80%. Death occurred in 59 patients (20%), with higher mortality rates in those operated on after the age of 5 years, those with pulmonary vascular resistance greater than 7 units (51%), and those with complete heart block (78%). Of 37 patients with transient heart block after surgery, 8 (22%) have died (3 pulmonary vascular disease, 2 sudden death, 2 unknown causes and 1 complete heart block). Twenty other patients had a dysarrhythmia after surgery, and none of these died. Nine episodes of endocarditis occurred (11.4/10,000 patient years). Nine of 296 (3%) offspring had cardiac malformation. Most patients are in New York Heart Association class I, 57% attended college and 15% received an advanced degree. The data show good results for this group of patients operated on during an early era (1954 to 1960) of open cardiac surgery. They support the current trend toward operation in patients with ventricular septal defects at an early age and with low pulmonary vascular resistance.
Am J Cardiol 1991 Dec 01
PMID:Late results (30 to 35 years) after operative closure of isolated ventricular septal defect from 1954 to 1960. 174 32

In this report we study the value of ambulatory transesophageal echocardiography (TEE) in the clinical setting after a 2-year experience at our department. Since December 1988 until February 1991, 470 TEE examinations were indicated in 430 patients. Excluded were 8 cases, two out of them due to a formal contraindication and six who did not tolerate the procedure. The clinical indications for the examination, in the 462 studies performed, were as follows: possible cardiac source of emboli in 165 (35%); native mitral valve disease in 91 (20%); prosthetic valve dysfunction in 54 (12%); diseases of the aorta in 44 (10%); suspected infective endocarditis in 41 (9%); study of left ventricular function in 26 (6%); congenital heart disease in 18 (4%); tumor or intracardiac mass in 11 (2%); miscellaneous in 12 (2%). Based on this experience, we can conclude that TEE is a clinically useful technique for: 1) the study of mitral regurgitation, either native or prosthetic; 2) the detection of vegetations and abscesses in infective endocarditis; 3) the evaluation of a possible cardiac source of emboli; 4) the examination of the aorta in cases of suspected dissection; 5) the completion of the anatomic study in some congenital heart diseases, particularly after a surgical correction; 6) the study of patients with a technically inadequate transthoracic approach.
Rev Esp Cardiol
PMID:[Ambulatory transesophageal echocardiography: 2 years of experience]. 175 25


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