China
Africa
Explore chapters and articles related to this topic
Valve Disease
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
TAVR is now well established with a procedural success rate of 90%. Possible complications to TAVR include conduction disturbances and the need for a permanent pacemaker. The aetiology of conduction abnormalities is the cardiac anatomy (length of membranous septum, degree of calcification, location of left bundle within the membranous septum), baseline conduction abnormalities (preprocedure right bundle branch block), and procedural variables (type of valve, depth of implant). Other complications include stroke, paravalvular leak, vascular site complications, bleeding, annular rupture, left ventricular perforation, cardiac tamponade, myocardial infarction due to calcific emboli into intramural vessels, acute kidney injury, infection, hypotension and death. The 30-day mortality rates have varied from 3% to 15%. Autopsy on patients who undergo TAVI reveal specific patterns of cardiovascular pathology that clearly relate to the time interval between TAVI and death and significantly adds to the clinical diagnosis. Cardiogenic shock is the cause of death followed by sepsis and respiratory failure in early post-operative. Later complications include sepsis, caused by infective endocarditis in many cases.22
Paper 4
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Infective endocarditis must be considered in a patient with fever and a heart murmur. These and haematuria and splenomegaly make up the four cardinal signs. Endocarditis can affect normal heart valves, abnormal heart valves or even prosthetic valves. Causative organisms include Streptococcus viridans, Staphylococcus aureus, Coxiella or Chlamydia. Endocarditis can also be non-infective, e.g. with systemic lupus erythematosus. Blood cultures (three sets), urine dipstick, chest x-ray and echocardiography are all essential investigations. Intravenous antibiotics are the treatment of choice though in certain situations valve replacement may also be warranted.
Splinter Haemorrhages
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
This patient has longitudinal splinter haemorrhages in the nail beds of the fingers on the right hand (or wherever they are). There are no other obvious signs of infective endocarditis (or list them if there are).
Effect of promethazine on biofilms of gram-positive cocci associated with infectious endocarditis
Published in Biofouling, 2023
Gláucia Morgana de Melo Guedes, Carliane Melo Alves Melgarejo, Alyne Soares Freitas, Bruno Rocha Amando, Cecília Leite Costa, Crister José Ocadaque, Francisco Ivanilsom Firmiano Gomes, Silviane Praciano Bandeira, Rossana de Aguiar Cordeiro, Marcos Fábio Gadelha Rocha, José Júlio Costa Sidrim, Débora de Souza Collares Maia Castelo-Branco
The American Heart Association (AHA) estimates that about 100,000 to 200,000 new cases of infective endocarditis are diagnosed in the United States of America (USA) each year, and recent data showing an increase in incidence in USA and UK (Yang et al. 2015; Hubers et al. 2020). Endocarditis is usually caused by an infection, where an endothelial cardiovascular presents an inflammatory structure of platelets and fibrin commonly observed with growth of vegetations composed of microorganisms, which can be considered a pathognomonic sign of the disease (Cahill and Prendergast 2016; Pecoraro and Doubell 2020). The main etiological agents are Gram-positive cocci, with emphasis on the genera Staphylococcus spp. and Streptococcus spp. (Htwe and Khardori 2012). To treat the infection, several drug regimens can be used, most of which include oxacillin or vancomycin against Staphylococcus spp. and ceftriaxone or vancomycin against Streptococcus spp., with vancomycin as the last drug resource (Gould et al. 2012; Habib et al. 2015).
The role of dalbavancin for Gram positive infections in the COVID-19 era: state of the art and future perspectives
Published in Expert Review of Anti-infective Therapy, 2021
Massimo Andreoni, Matteo Bassetti, Salvatore Corrao, Francesco Giuseppe De Rosa, Vincenzo Esposito, Marco Falcone, Paolo Grossi, Federico Pea, Nicola Petrosillo, Carlo Tascini, Mario Venditti, Pierluigi Viale
Infective endocarditis (IE) is an infectious process involving the endocardial surface of intracardial structures, such as heart valves, both native or prosthetic, or intracardial implantable medical devices. Based on the clinical manifestations of the disease, IE can be further classified in acute or subacute. While acute endocarditis generally present with a sudden onset of fever or systemic complications, subacute endocardial infections are often misdiagnosed because of unspecific symptoms lasting over weeks or months such as fatigue, dyspnea or weight loss. The most commonly isolated pathogen in blood cultures of patients with IE is Staphylococcus aureus, followed by Viridians group streptococci and by enterococci which are typical for the elderly. Coagulase negative Staphylococci are a leading cause of infective endocarditis involving prosthetic valves or intracardiac devices. Due to frequent antibiotic resistance and difficult medication penetration into bacterial endocardial vegetations, IE often require a combined and prolonged intravenous antimicrobial therapy and debridement and valve replacement surgery [31,32]. Dalbavancin is not currently approved for the treatment of IE; nevertheless, because of its activity spectrum and pharmacokinetic properties, it may be a promising alternative in this clinical setting, reducing hospitalization duration and assistance costs.
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.