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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infective endocarditis can be complicated by the development of intra-cardiac shunts. A case of endocarditis secondary to staphylococcal septicaemia is reported where various conduction defects preceded the development of a fistula from the aortic root to the right atrium. Before emergency surgery there was marked worsening of heart failure with the appearance of a new loud murmur throughout diastole.
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PMID:Staphylococcal aortic valve endocarditis with aortic root to right atrial fistula. 68 11

The aim of this study was to report the authors' experience of infective endocarditis (IE) from 47 cases collected between 1976 to 1991. Infective endocarditis (IE) was documented with surgical (n = 9), microbiological (n = 26), and echocardiographic (n = 30) criteria. There were 11 male, 36 female: mean age, 26.2 +/- 10.3 years (extremes: 17 and 47). The authors noted a great importance of gynecological portal entry (13 cases), acute infective endocarditis (23 cases i.e. 48.9%), heart failure (39 cases i.e. 82.9%), and pulmonary (4 cases i.e. 8.5%) and systemic (8 cases i.e. 17.0% embolism. Surgical treatment was impossible in Brazzaville. Trans-thoracic echocardiography was performed in 38 cases and revealed vegetations in 30 cases i.e. 78.9%. Twenty patients died (42.5%) because heart failure. There was no significant difference in letality between infective endocarditis treated surgically or no, between native valve or prosthetic valve infective endocarditis, between culture negative or culture positive infective endocarditis (IE). This study corroborate that infective endocarditis is a heavy illness, characterized by high frequency of heart failure. The authors insist upon the prevention of infective endocarditis.
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PMID:[Infectious endocarditis. Experience of a service in Brazzaville. 47 cases]. 143 88

Infective endocarditis remains even today a potential lethal disease. The most frequent bacterial agents are viridans streptococci, staphylococci and enterococci. Left-sided endocarditis predominates except for patients with drug addiction. Modern recommendations of treatment are based on in vitro studies, experimental data from the animal model and clinical studies. Antimicrobial therapy should be parenteral and bactericidal in character. Detailed recommendations for treatment are given. Progressive heart failure, persistent bacteremia and repeated embolism are the most important reasons for surgical intervention. Modern prevention is performed as single or short-term prophylaxis for about sixteen hours. Simple practicability as well as handing out of guidelines to the patient will contribute to improved acceptance.
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PMID:[Therapy and prophylaxis of infectious endocarditis]. 185 6

Cardiac involvement is being identified more often clinically and at autopsy in patients with AIDS. Recent estimates suggest that in the United States as many as 5000 patients per year may have cardiac complications resulting from HIV infection. Patients with AIDS may have pericardial, myocardial, and/or endocardial disease. Pericardial tamponade and/or constriction may be related to neoplasms, infections, or nonspecific effusions. Myocardial dysfunction may result from specific neoplastic infiltration or myocarditis. Particularly intriguing is the role of HIV-1 in the nonspecific myocarditis and dilated cardiomyopathy that occurs in patients with AIDS. As in other debilitating conditions patients with AIDS can have nonbacterial thrombotic endocarditis. Infective endocarditis may be a complication, especially in AIDS associated with intravenous drug abuse. Most patients with AIDS have no overt clinical evidence of cardiac disease. When cardiac dysfunction does develop, the signs and symptoms are often misinterpreted to be the result of noncardiac causes (pulmonary failure or infection) which can mimic heart failure. This review is intended to alert the reader to the cardiac manifestations of AIDS, which present a number of diagnostic and therapeutic challenges.
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PMID:Cardiac manifestations of acquired immune deficiency syndrome: a 1991 update. 185 38

Infective endocarditis is best characterized as a disease in evolution. The list of patients at risk, which formerly included almost exclusively patients with rheumatic heart disease, is being continuously modified and expanded. Nowadays, patients with prosthetic heart valves, users of illicit intravenous drugs, and patients with mitral valve prolapse rather than patients with rheumatic heart disease account for the majority of cases of infective endocarditis. Moreover, due to the widespread use of indwelling atrial catheters for parenteral nutrition as well as for intensive cytotoxic therapy, catheter-related right-sided endocarditis is emerging among nosocomial infections. With the advent of successful antimicrobial therapy, complications rather than endocardial infection pose the major therapeutic problems. In addition to progressive heart failure, myocardial abscesses, fungal endocarditis, relapsing infection, and major systemic emboli in the presence of large protuberant vegetations constitute indications for replacement of the valve. Despite progresses in diagnosis and therapy, infective endocarditis will most likely continue to challenge physicians even in the next future.
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PMID:[Infective endocarditis: a changing disease]. 209 78

Infective endocarditis (IE) is a severe and relatively common condition in parenteral drug abusers (PDA). Seventy-one IE episodes in 59 PDAs admitted to the Hospital General Vall d'Hebron from August 1978 to December 1988 were evaluated. The disease basically involved young males, with a progressively increasing incidence throughout the decade and a higher frequency during August. Fever was a constant symptom, with a duration of less than 10 days before admission in 73% of cases. Staphylococcus aureus was the most common pathogen (85% of episodes). Vegetations were detected by echocardiography in 70% of cases. In 82% of episodes the right side of the heart was involved, particularly the tricuspid valve. The initial chest X-ray film was abnormal in 57.5% of episodes. In 7 patients features of heart failure were present at admission; most had left heart endocarditis. Three patients with left heart endocarditis required surgical therapy. Overall mortality was 13%; it was 6% in patients with only tricuspid involvement and 27% when the left heart was involved.
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PMID:[Infectious endocarditis in drug addicts: a study of 71 cases]. 223 52

Infective endocarditis is not a simple interaction between a microbial agent and a cardiac valve. For the infection of a non-bacterial thrombotic vegetation, predisposition is required which is at least partially operative by a decreased suppressor T cell activity. During infection, peripheral blood natural killer cell activity is decreased, but normalizes under anti-microbial therapy. Non-major histocompatibility complex-restricted lymphocytotoxicity to isolated heart cells can be present in one third of patients. Circulating immune complexes normalize during therapy. They may be the cause of many clinical symptoms of infective endocarditis. Anti-bacterial and also anti-sarcolemmal antibodies which are cross-reactive to the bacterium are secreted in a polyclonal immune response. Anti-sarcolemmal antibodies which are cytolytic in vitro in the presence of complement may partly explain the myocardial factor of heart failure in patients with only marginal valve incompetence due to the endocarditic vegetation.
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PMID:Autoreactive mechanisms in infective endocarditis. 269 10

The long-term results (5 to 12 years) of 77 patients with Smeloff-Cutter aortic valve prostheses are reported. These patients were comparable in age, preoperative clinical condition and type of aortic valve replacement. The postoperative follow-up period of this series was however significantly longer. The 5 year survival rate was of 87%. The causes of death included thromboembolism, infectious endocarditis and cardiac failure. Mortality was higher in the first 5 postoperative years : 2,4% patient-years compared to 1,5% patient-years in the following years. Thromboembolism and neurological complications were particularly rare, representing a risk of 1,04% patient-years but these complications were lethal in half the cases in which they occurred. No haemolytic complications were observed. Infective endocarditis always occurred in patients with a history of infection, the complication usually being late (after 3 years). The life expectancy of patients seen after 5 years is at least 5 additional years in 80% of cases. The haemodynamic profile of the prosthesis did not degrade with time. After 5 years, 58,6% of patients in functional Class IV at operation were in Class I or II afterwards. 84,4% of patients operated in functional Class III were in Class I or II, and 93% operated in functional Class II were in Class I or III. A control of 3 prostheses carried out by the Cutter laboratory after 10 and 11 years' function shows practically no deterioration of the prosthesis. The low incidence of thromboembolism, the absence of haemolysis and long-term deterioration of the prosthesis are particularly valuable characteristics of this prosthesis in the aortic position.
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PMID:[Long-term course of patients with Smeloff-Cutter aortic valve prosthesis]. 679 68

Infective endocarditis (IE) during pregnancy is uncommon. A 31-week-pregnant, 21-year-old woman suffered from severe mitral regurgitation caused by IE. She fell into heart failure and threatened abortion. Following to cesarean section, an emergent mitral valve replacement with a bioprosthetic valve was successfully performed. Her postoperative recovery was uneventful and she was discharged home 30 days after the operation. Her baby, however, died of intracranial hemorrhage caused by hypoxia 171 days after delivery. A strategy of simultaneous open heart surgery and cesarean section is recommended when emergent open heart surgery is inevitable for the treatment of cardiac diseases in cases with 24 and/or more weeks' gestation.
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PMID:[Simultaneous cesarean section and mitral valve replacement for infective endocarditis during pregnancy--a case report]. 847 4

Infective endocarditis, especially when it involves prosthetic valves, is a serious, often fatal illness. Although antibiotics are essential in management, surgery is required in many patients who develop even incipient heart failure and structural complications. Early identification and referral results in improved mortality and morbidity rates, and there is evidence that surgery should play a larger role in managing infective endocarditis. Patients with intracardiac pacemakers and cardioverting devices represent a growing reservoir of patients with the potential to develop endocarditis.
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PMID:Indications for and timing of surgical intervention in infective endocarditis. 885 33


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