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Investigation of Sudden Cardiac Death
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Infective endocarditis is associated with significant morbidity and mortality in patients with adult congenital heart disease.52 In a recent study we published on 30 cases, the main lesion was a bicuspid aortic valve. SCD is due to perforation of the valve leaflets or embolization into the coronary circulation.53 Endocarditis can occur in CHD especially with interventions and valve replacements.54
Case 4
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
The diagnosis of infective endocarditis is definite when: (a) a microorganism is demonstrated by culture of a specimen from a vegetation, an embolism or an intracardiac abscess; (b) active endocarditis is confirmed by histological examination of the vegetation or intracardiac abscess; (c) two major clinical criteria, one major and three minor criteria, or five minor criteria are met (Table 4.1).
Stroke and Transient Ischemic Attacks of the Brain and Eye
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Infective endocarditis is caused by microbial infection of the endocardial surface or of prosthetic material in the heart. More than 80% of cases are caused by Staphylococcus aureus or by species of Streptococcus or Enterococcus. The annual incidence is 3–10 cases per 100,000.
Sensitivity, specificity and predictive values of ICD-10 substance use codes in a cohort of substance use-related endocarditis patients
Published in The American Journal of Drug and Alcohol Abuse, 2022
Yael Campanile, Michael Silverman
A review of patient medical records was conducted to determine infective endocarditis status. We used hospital documents such as admission, discharge and consult notes as well as laboratory, radiologic, echocardiographic, and microbiologic data to confirm the infective endocarditis status. We defined infective endocarditis according to the modified Duke criteria for the diagnosis of Definite infective endocarditis. In our local institutions, questions about substance use and the types of drugs used are routinely asked and the responses are routinely recorded as part of general medical care. Substance use was assigned based on documentation in the medical record of self-reported recent or current injection drug use. Patients were categorized as using opioids, stimulants (Methamphetamine or Cocaine), or mixed substance, based on self-reported drug use within 3 months of presentation, as reported within clinical documentation, and informed by drug screening (available in 66% of cases). If urine drug screening demonstrated substances that the patient denied using, the urine drug screen was used to define drugs used. Opioids included hydromorphone (controlled and immediate release), morphine, fentanyl, heroin, and oxycodone. Stimulants included methamphetamine, cocaine, bupropion, and methylphenidate. Reported use of methadone or buprenorphine orally for opioid substitution therapy for previous opioid use was not categorized as opioid use for the purpose of analysis, as these drugs were not generally injected.
Infection of cardiac prosthetic valves and implantable electronic devices: early diagnosis and treatment
Published in Acta Cardiologica, 2021
Lampros Lakkas, Burcu Dirlik Serim, Andreas Fotopoulos, Ioannis Iakovou, Argyrios Doumas, Ulku Korkmaz, Lampros K. Michalis, Chrissa Sioka
The modified Duke criteria offer a reliable approach to diagnose endocarditis due to prosthetic valve and CIED infection [5]. In this regard, echocardiography still remains the cornerstone for the diagnosis of endocarditis. The three major echocardiographic findings which are regarded as major diagnostic criteria are: oscillating intracardiac mass (vegetation), abscess formation and valve dehiscence in prosthetic valves. There are also other echocardiographic features concerning the diagnosis of infective endocarditis (aneurysms, intracardiac fistulae, small perforations and other non-specific findings). Overall, echocardiography represents a rather fast, inexpensive and accurate imaging modality [17]. However, one of its limitations there is its low diagnostic efficacy in cases with prosthetic materials, such as valves and pacemaker or defibrillator leads. Recently, advances in other imaging modalities, apart from echocardiography, have resulted in further diagnostic improvement. Thus, the European Society of Cardiology published in 2015 a modified diagnostic algorithm for the diagnosis of infective endocarditis in prosthetic valves that include the use of FDG PET/CT as an additional imaging modality [18].
Infective endocarditis initially manifesting as pseudogout
Published in Baylor University Medical Center Proceedings, 2021
Tim Brotherton, Chad S. Miller
Infective endocarditis (IE) is a bacterial infection of the endocardium that often affects the heart valves. Risk factors for IE include preexisting valvular disease, a recent dental procedure, and intravenous drug use. The most commonly isolated bacteria is Staphylococcus aureus. In 2009, there were over 40,000 hospital admissions for IE, with admissions increasing in each of the five prior decades.1 Prompt diagnosis and treatment are paramount due to the mortality rate; estimated in-hospital mortality alone was 19.7% in the 2000s.2 Common symptoms include fever, chills, fatigue, arthralgias, myalgias, cardiac manifestations, and extracardiac manifestations that are attributed to embolic disease and immune complexes. Our case describes what appears to be an extremely rare occurrence of IE manifesting initially with pseudogout of the ankle. IE commonly manifests with musculoskeletal symptoms and can mimic other diseases. However, an association between IE and pseudogout has not been illustrated.