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)

A 65 year-old-man was admitted to our hospital complaining of orthopnea and precordial oppressive feeling. Chest roentgenogram revealed congestive heart failure. Electrocardiogram revealed acute myocardial infarction-like pattern. Serum enzymes (CPK, GOT, LDH) were slightly elevated, but serum antiviral antibodies were not elevated. Echocardiogram showed severe symmetrical left ventricular (LV) hypertrophy, but there was no abnormality of LV wall motion. He died of progressive heart failure and ventricular fibrillation on the second hospital day. A necropsy was performed within one hour of death. The heart was enlarged (690 g) with both left and right ventricular hypertrophy. The myocardium disclosed a diffuse infiltration predominantly of eosinophilic leucocytes. Histopathological study revealed giant cell formation and granulomatous lesions in the myocardium. There was no overt endocarditis or pericarditis. We concluded that the severe LV hypertrophy was due to myocardial inflammatory swelling. From these findings, we diagnosed this case as acute isolated (Fielder's) myocarditis.
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PMID:[A case of acute isolated (Fiedler's) myocarditis diagnosed by histopathological study with rapid unfortunate course]. 158 53

A total of 99 cases of viridans streptococcal endocarditis encountered during the period of 1973 and 1990 at the Veterans General Hospital-Taipei were reviewed to evaluate its prognostic factors. Applying strict clinical and laboratory criteria, 24 cases were categorized as definite, 44 probable, 23 possible and 8 likely. The symptoms were frequently subtle and atypical but initial laboratory tests gave useful indications: 69.1% with leukocytosis, 78% with anemia, 58.5% with elevation of LDH level, 88.9% with elevation of ESR value and 100% with elevation of CRP level. Furthermore, 32.4% of the cases demonstrated proteinuria and 67.4% microscopic hematuria. Seventy-three of the subjects had a history of underlying heart disease, predominantly rheumatic heart disease. Histological examination and echocardiography revealed that 51 patients suffered from vegetative endocarditis, 7 (13.7%) of whom were found to have anatomically confirmed vegetations without initial echocardiographic evidence, Vascular events were seen in 61 cases (61.6%): peripheral stigmata (32 cases), cerebral vascular accidents (17 cases), pulmonary embolism (10 cases) and others (2 cases). The overall mortality rate was 18.2%. Congestive heart failure with embolization was the most common cause of death in this group. The presence of vegetation was not well correlated with embolic events. There was no statistically significant association between the mortality and the following characteristics: age, sex, underlying heart disease, evidence of echocardiographically detected vegetations, major surgical intervention and recurrent cases except for embolic events (p less than 0.01). In conclusion, viridans streptococcal endocarditis complicated embolic events usually presented with a fulminant course and a grave outcome.
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PMID:Overview of viridans streptococcal endocarditis: clinical analysis of 99 cases. 165 35

The St. Jude Medical cardiac valve is a low-profile, bileaflet, central-flow prosthesis made of pyrolitic carbon. During a 39-month period (October 1, 1979 to December 31, 1982) a total of 169 St. Jude valves were implanted in 155 patients. While 141 patients received one valve, 95 in the aortic, 45 in the mitral and 1 in the tricuspid position, 14 patients had a double (aortic and mitral) valve replacement. The perioperative mortality rate was 3.2%. All surviving patients had anticoagulation treatment with acenocoumarol and there was a 98% follow-up during a period of 19.5 +/- 4.5 months. The late mortality rate was 4.7%. Substantial clinical improvement resulted with the St. Jude valve: whereas 81.9% of patients were in NYHA functional class III or IV preoperatively, 87.1% were in class I or II after valve replacement. The patients generally had a slight increase in LDH levels but hemolysis was responsible for moderate anemia only in 5 cases. There were 10 nonfatal neurological accidents, probably due to thromboembolic events, resulting in a risk of thromboembolism of 4.04% per patient year; 4 of the 10 patients were incompletely anticoagulated and 3 had cardiac arrhythmia. There were 5 hemorrhagic complications, one of which was fatal (subarachnoidal hemorrhage). Endocarditis occurred in 4 patients and death ensued in one of these. Seven patients developed perivalvular leak which was moderate in 5 cases and severe in 2 cases. In conclusion, these results are promising and the St. Jude Medical cardiac valve appears to be a valid alternative in surgical therapy of valvular heart disease. However, the risk of thromboembolism justifies long-term anticoagulation.
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PMID:[The artificial St. Jude valve: clinical course and complications recorded in 155 patients]. 651 67

After aortic valve replacement for endocarditis, follow-up treatment with antibiotics is imperative. However, the question of how reliable preoperative and intraoperative diagnosis of endocarditis is in cases involving aortic defects is unclear. Of the 187 patients who underwent aortic valve replacement with or without coronary bypass surgery between June 1992 and June 1994, 150 exhibited no indications of endocarditis during preoperative and intraoperative examinations. In 17 cases (Group A) histological findings indicated acute florid endocarditis in 7 patients and chronic lymphocytic endocarditis in 10. Contrarily, histological examinations of 133 patients (Group B) revealed myxoid and/or sclerotic valve degeneration. WBC and LDH activity, examined one day preoperatively and on the first and second days postoperatively, exhibited no significant differences between the two groups, with the exception of LDH activity on the first postoperative day (Group A: 490 +/- 114, Group B: 403 +/- 132, p = 0.04). Of the clinically asymptomatic patients requiring aortic valve replacement, 11.3% exhibited acute florid endocarditis upon histologic examinations. This subgroup cannot be identified based upon routine preoperative or postoperative laboratory tests or intraoperative observation. Histological examination of the aortic valve is useful for identifying the high percentage of otherwise nonidentifiable endocarditis. Further study will be required to determine therapeutic recommendations based upon such diagnosis.
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PMID:[Asymptomatic endocarditis? Are consequent histological studies useful in valve surgery?]. 865 70

The new Duromedics Bileaflet Cardiac Valve prosthesis has a special moving hinge mechanism for its two leaflets to wash the critical articulation area and thus reduce thrombus formation. Between October 1983 and June 1985, we implanted 278 of these prostheses in 254 patients. We did 114 aortic valve replacements, 109 mitral valve replacements, 34 double valve replacements, and two tricuspid valve replacements. Nearly 20% of the patients had had previous cardiac procedures. The hospital mortality was 5.9%. Follow-up was started with 214 surviving Austrian patients, and up to the present time, we have a follow-up period of 1704 patient months. Five patients died late after the operation (3.5 per 100 patient years). We observed 10 valve-related complications in nine patients (7 per 100 patient years). There were three cases of prosthetic endocarditis (2.1 per 100 patient years), two paravalvular leaks, and four bleeding episodes (2.8 per 100 patient years). The mechanical hemolysis was minimal, and the postoperative hemoglobin value averaged 15 g%. The LDH increased from 230 IU to 307 in the aortic valve replacements, 406 in the mitral valve replacements, and 435 in the double valve replacements. Intraoperative pressure gradients and postoperative Doppler echocardiography showed good hemodynamic performance. We conclude that good clinical results and a low complication rate can be achieved with the Duromedics Valve.
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PMID:Two years' experience with the duromedics bileaflet heart valve prosthesis. 1522 87

Clinical cases of renal infarction are rarely seen and often either misdiagnosed or initially treated as something else. In most circumstances, renal infarctions are discovered accidentally, not due to a consideration of the diagnosis. A review of the literature reveals that we ought to search for the entity in patients with risk factors such as atrial fibrillation, infarction history or potential, mitral stenosis, infective endocarditis, atrial or ventricular septal defect, hypertension and ischemic heart diseases. In addition, the rise of LDH (lactate dehydrogenase) in serum and the presence of hematuria serves as a good indicator of the malady. We present two cases we encountered early this year in our Emergency Department. In both cases, white blood cell count and LDH showed significant increases, but there was no hematuria present. Both were successfully treated with LMWH (low-molecular-weight heparin). Upon discharge, both patients regained normal renal function.
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PMID:Renal infarction without hematuria: two case reports. 1643 37

Ischaemic stroke in thromboembolic mechanism may be a first sign of neoplastic disease, as in the presented case of a 56-year-old woman. Progressive trombocytopenia, anaemia with reticulocytosis and schistocytes in peripheral blood smear, elevated serum LDH activity as well as coexisting myocardial infarction initially suggested Moschcowitz syndrome. However, plasma exchange did not improve her neurological status and D-dimer values increase in subsequent evaluations indicated chronic DIC. At the same time, on transesophageal echocardiography, thrombotic endocarditis was diagnosed. Screening for cancer showed high CA 125 marker and chest computed tomography revealed lung tumor, not visible on earlier chest X-ray. In further treatment she underwent palliative radiotherapy and continued low molecular weight heparin. The neoplastic process had an unfavorable course and she died after four months. The authors point out that in case of multifocal ischaemic stroke and coexistent thrombocytopenia, neoplastic hypercoagulable state and thrombotic endocarditis should be considered.
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PMID:[Multifocal ischaemic stroke and myocardial infarction in a woman with occult lung cancer complicated with chronic DIC and thrombotic endocarditis]. 1719 80