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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with enterococcal endocarditis of 11 months' duration is presented, and the role of surgery and echocardiography is reviewed. Echocardiography revealed vegetations of the aortic and mitral valves. After appropriate antibiotic therapy the patient had successful aortic and mitral valve replacement with porcine heterografts. Enterococcal endocarditis is increasing in frequency and is likely to infect young women of childbearing age, elderly men who have had genitourinary tract manipulation, and abusers of intravenous drugs. Aortic and mitral valves are most frequently affected, cardiac failure is common, and often no evidence of underlying heart disease can be found. The use of echocardiography in this patient provided accurate diagnosis of valvular vegetations and assessment of the hemodynamic severity of the lesion, thus preventing the need for cardiac catheterization and its potential risk of septic embolization.
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PMID:Multivalvular vegetations in a patient with enterococcal endocarditis diagnosed by echocardiography. 9 35

Cardiology was diagnosed by means of clinical, radiographic, electrocardiographic phonocardiographic, angiocardiographic, and pathological findings in 271 or 3,745 cats necropsied from January 1962 to April 1974. The affected cats can be divided into three groups on the basis of the gross and microscopic pathological lesions: 1)endocarditis and myocarditis in 20 young cats; 2)endomyocardial fibrosis and left ventricular hypertrophy in 182 cats; and 3)myocardial degeneration and biventricular dilatation in 69 cats. Of 271 affected cats, thromboembolus was observed in the aorta, and in the carotid, femoral, iliac, renal, pulmonary, and hepatic arteries in 104 instances. The important aspects of cardiomyopathy in cats appears to be the reduced diastolic compliance of the thick left ventricle, resulting in poor fillin. Resistance to ventricular inflow raises the diastolic pressure and causes compensatory left atrial enlargement. A pathogenesis for the onset of clinical signs at any stages as the cause of the heart disease is postulated on the basis of stress causing tachycardia and poor left ventricular filling. Acute left-sided failure with pulmonary edema may be precipitated. Approximately one-fourth of the cats have enlargement of all cardiac chambers, typical of congestive cardiomyopathy. On the basis of the close similarily to cardiomyopathy in man, the cat could serve as a suitable animal model for a conservation of time and effort in the attack against this disorder. There is a need for coordinated research programs for utilizing the multiple avenues of approach such as: epidemiological, clinical, biochemical, pathological, ultrastructural, virological, and immunological.
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PMID:Feline cardiomyopathy. 12 93

Five heroin addicts were treated for endocarditis caused by Pseudomonas cepacia. Two of these infections occurred in patients with no known heart disease whereas the others occurred at sites of previous endocarditis or valve prostheses. Infection was indolent in four patients but was associated with shock and skin lesions suggestive of ecthyma gangrenosum in the fifth. After failure of chloramphenicol and kanamycin, all patients were treated with a combination of sulfamethoxazole, trimethoprim and polymyxin plus heart valve resection or replacement.
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PMID:Subacute and acute endocarditis due to Pseudomonas cepacia in heroin addicts. 16 59

A retrospective study of group B streptococcal endocarditis during 1965-74 in Aberdeen General Hospitals revealed that group B streptococci how principally affect patients in the older age groups with or without a history of antecedent heart disease. Despite recent reports of increased group G infections in obstetric and perinatal practice there were no cases of post-puerperal endocarditis. Although aortic valve involvement would appear to be increasing, group B streptococci still show a marked predilection for the mitral valve.
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PMID:Group B streptococcal endocarditis. 31 29

Patients with bacteriuria are at risk for local and distant infectious complications at the time of urologic procedures. The American Heart Association recommends that penicillin and streptomycin be given prophylactically to patients with rheumatic or congenital heart disease without reference to the presence or absence of bacteriuria. A patient with unrecognized calcification of the mitral annulus who underwent cystoscopy for evaluation of urinary retention is reported. Although bacteriuria was present preoperatively antibiotics were not given. Subsequently, Serratia marcescens and possibly Proteus morgani mitral valve infection developed and the patient died. Calcification of the mitral valve annulus and an extensive urinary tract infection were identified at autopsy. This case suggests that calcification of the mitral annulus may be an endocarditis risk factor. The spectrum of prophylactic antibiotic coverage given at the time of urologic procedures to patients with congenital or aquired heart disease, including calcification of the mitral annulus, should include whatever organisms are present in the urine.
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PMID:Gram-negative endocarditis following cystoscopy. 34 Jul 13

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.
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PMID:Indications for surgical replacement of the mitral valve. With particular reference to common and uncommon causes of mitral regurgitation. 37 33

We describe a case of Hemophilus parainfluenzae endocarditis in a previously healthy 26-year-old man, and review 21 cases from the literature. Although H parainfluenzae is considered to be part of the normal flora of the upper respiratory tract in man, it can cause serious disease. H parainfluenzae endocarditis is often difficult to diagnose. The patients generally had a history of recent infection of the upper respiratory tract, but a majority denied previous heart disease. Upon entry to the hospital, after an average of seven weeks of febrile illness, nearly one third of patients were found not to have a heart murmur. Furthermore, the organism was often difficult to grow from blood cultures, a problem possibly related to the need for accessory growth factors. The mortality with modern therapy was 12%, and the major complication was cerebral embolus. Antibiotic therapy of choice is ampicillin, generally used together with an aminoglycoside, though ampicillin alone may be sufficient.
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PMID:Hemophilus parainfluenzae endocarditis. 44 62

Haemophilus parainfluenzae endocarditis is characterized by great variation in the acuteness of presentation, difficulty in isolation of the pathogen, a 50% to 60% incidence of major arterial emboli, and variability of response to therapy. Prosthetic valve endocarditis (PVE) due to H parainfluenzae biotype II occurred in a 14-year-old girl with congenital heart disease and a Starr-Edwards mitral valve prosthesis. Management was complicated by a prolonged culture-negative period (eight days), intermittent bacteremia (only five of 15 positive blood cultures), an embolus to the right femoral artery, progressive congestive heart failure, and urgent prosthestic valve replacement. Cure was achieved with 44 days of ampicillin sodium-gentamicin sulfate therapy monitored by serum bactericidal titers.
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PMID:Prosthetic valve endocarditis due to Haemophilus parainfluenzae biotype II. 44 17

This study included 40 patients over 60 years of age with echocardiographic findings of mitral valve prolapse (MVP). Most of these patients were unaware of any cardiac disorder until the time of echocardiography. In the majority, the clinical manifestations were benign, and the duration of symptoms variable. Congestive heart failure (CHF) was noted in 10 patients (25 percent) who were unaware of having any cardiac disorders until the onset of their symptoms. In 5 patients (4 with CHF and 1 with endocarditis), surgical replacement of the prolapsed mitral valve was necessary. Endocarditis was present in 4 patients (10 percent), none of whom had been instructed in the prophylactic use of antibiotics. The physician's awareness of mitral valve prolapse in the elderly patient is important, since the disorder may not be as benign in aged patients as in younger ones, and life-threatening complications may occur.
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PMID:Mitral valve prolapse in the elderly. 46 55

Since the introduction of penicillin in 1942, there have been only 11 culture-proven cases of gonococcal endocarditis in the English literature. Most patients are under 30 years of age and have no history of heart disease. The aortic valve is often involved and aortic regurgitation is common. The bacteriologic diagnosis can be difficult and may require more than six blood cultures and a long incubation period. Circulating immune complexes appear to be the cause of many of the extracardiac manifestations. The three new cases reported herein and review of the literature emphasize the distinctive features of gonococcal endocarditis.
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PMID:Gonococcal endocarditis in the antibiotic era. 50 21


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