Infektif Endokarditis Pada Penyakit Jantung Tiroid

Infective endocarditis is an endocardial surface infection of the heart including heart valves that can be fatal. Occurs because there is damage to the surface of the endocardium and the entry of bacteria into the circulation. The presence of cardiac lesions such as mitral regurgitation can be a predisposing factor for infective endocarditis. Patients were diagnosed with infective endocarditis based on a scoring system consisting of clinical symptoms, imaging, and blood culture findings, namely: modified Duke criteria. Treatment of infective endocarditis consists of giving antibiotics and evacuating vegetation by surgery. Surgical action is indicated if there is symptoms of heart failure, uncontrolled infections and vegetation size are too large, causing the risk of embolism.

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Infective Endocarditis

The Brigham Intensive Review of Internal Medicine ◽

10.1093/med/9780199358274.003.0003 ◽

2014 ◽

pp. 18-26

Author(s):

Anju Nohria

Keyword(s):

Heart Failure ◽

Infective Endocarditis ◽

Heart Valves ◽

Interventricular Septum ◽

Inflammatory Cells ◽

Chordae Tendineae ◽

Systemic Complications ◽

Fungal Endocarditis ◽

Mycotic Aneurysms ◽

Endocardial Surface

Infective endocarditis (IE) is an infection of the endocardial surface of the heart. It is characterized by one or more vegetations, which comprise a mass of platelets, fibrin, microorganisms, and inflammatory cells. IE primarily involves the heart valves (native or prosthetic). Other structures may also be involved, including the interventricular septum, the chordae tendineae, the mural endocardium, or intracardiac devices such as a pacemaker. The most common infective causes are bacterial; however, fungal endocarditis can be seen in patients who are immunocompromised. There is controversy about the existence of viral endocarditis. Valvular involvement in IE may lead to congestive heart failure, conduction abnormalities, and myocardial abscesses. Systemic complications in IE include embolization of both sterile and infected emboli, abscess formation, and mycotic aneurysms.

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Abstract WP335: Intracranial Mycotic Aneurysms in Infective Endocarditis: Incidence, Predictors and Outcome

Stroke ◽

10.1161/str.48.suppl_1.wp335 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Mehmet A Topcuoglu ◽

Oguzhan Kursun ◽

Ferdinando S Buonanno ◽

Aneesh B Singhal

Keyword(s):

Infective Endocarditis ◽

Mitral Regurgitation ◽

Multivariable Analysis ◽

Native Valve ◽

Duke Criteria ◽

Mycotic Aneurysms ◽

Mean Size ◽

Pre Treatment ◽

Cardiac Valve Disease

Introduction: Intracranial mycotic aneurysms (IMA) are rare but serious complications of infective endocarditis (IE). Methods and Results: In this retrospective study (1980-2011) we used original Duke criteria to diagnose IE in 1149 episodes (1081 patients; 81% definite, 80% native valve). Neuro complications occurred in 28%, stroke in 22% (202 infarcts, 53 hemorrhages) and 1% had TIA/TMB. N=33 IMA were detected in 23 (2%) patients. IMA were detected in 8% with focal neuro deficits, 13% with seizures, and 3% with encephalopathy. IMA-related symptoms were present in 22 of 23 cases: headache 48%, seizure 13%, altered sensorium 35% and focal deficits 61%. IMA were detected in 0/885 without stroke, 5.4% with infarcts and 22.6% with hemorrhages (p<0.001); the latter included 9/36 (25%) with ICH, 3/13 (23%) with SAH, and 0/4 with SDH. Of the 23 IMA patients 61% had hemorrhage, 30% had SAH and 57% had infarcts. IMAs were detected by DSA in 21/166 (12.7%). The mean size was 3.6±2.4 mm; 30% multiple; 61% located in distal segments; and 67% in MCA branches. On MRI, 31 had any SAH and 45 had any ICH; IMA detected in 6/9 with diffuse SAH, 2/22 with convexal SAH, 11/45 with ICH, and 11/202 with infarcts. Patients with IMA had higher rates of women, hypertension, known cardiac valve disease, mitral regurgitation, mitral vegetation and S.viridians infection (all p<0.05). On multivariable analysis, mitral regurgitation with vegetation (OR 5.9, 95% CI 2.5-14.0, p<0.001) was the only independent predictor of IMA. Clipping was performed in 8 (all pre-2000); endovascular treatment in 7 (all post-1997); 2 died pre- treatment; 1 detected on autopsy; 1 no follow-up available, and 4 regressed/disappeared with antibiotics. Patients with and without IMA showed no difference in rates of in-hospital mortality (22% v. 19%, p=0.93), and length of stay (32d v. 24d, p=0.28). IMA rates did not decrease during the study period (2.2% in 784 episodes 1980-2000 vs. 1.6% of 365 episodes 2001-2011, p=0.653). Conclusion: IMA are invariably heralded by neurological symptoms and stroke (especially hemorrhages) on brain imaging. Mitral IE has the highest risk for IMA. IMAs can resolve with antibiotics however studies are needed to determine the efficacy of different treatment approaches.

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P1088Match and mismatch between opening area and resistance in mild and moderate rheumatic mitral stenosisP1089When should cardiovascular magnetic resonance imaging be considered in patients with chronic aortic or mitral regurgitation?P1090Echocardiographic characteristics of aortic valve fenestration with aortic regurgitation for aortic valve repairP1091Aortic regurgitation assessment by 3D transesophageal echocardiography vena contracta area: usefulness and comparison with 2D methods.P1092Characterising cardiomyopathy in mitral regurgitation due to barlow disease: role of CMRP1093Compensatory peripheral increase in artero-venous o2 difference to severe functional mitral regurgitation in heart failureP1094Prognostic impact of concomitant atrioventricular valve regurgitation in patients undergoing transcatheter aortic valve implantationP1095Morphological characterization of vegetations by real-time three-dimensional transesophageal echocardiography in infective endocarditis: prognostic impactP1096Relation between causative pathogen and echocardiographic findings in patients with infective endocarditis: is there an association and is it clinically relevant?P1097Aortic and mitral valve infective endocarditis: different clinical and echocardiographic features and peculiar complication ratesP1098Vegetation size relevance and impact on prognosis in patients with infective endocarditisP1099Causes of death on the valvular heart disease surveillance list- a 5 year auditP1100Left ventricular non-compaction and idiopathic dilated cardiomyopathy: the significant diagnostic value of longitudinal strainP1101The role of echocardiography in the management of diuretics withdrawal in patients with chronic heart failure and severely reduced ejection fraction: a prospective cohort studyP1102Outcomes in paediatric new onset left ventricle dysfunction and dilatation: differences between post-myocarditis and DCMP1103De novo mitral regurgitation as a cause of heart failure exacerbation in hypertrophic cardiomyopathyP1104Correlation of conventional and new echocardiograhic parameters with sudden cardiac death risk score in patients with hypertrophic cardiomyopathyP1105Inverse correlation between myocardial fibrosis and left ventricular function in rheumatic mitral stenosis: a preliminary study with cardiac magnetic resonanceP1106Left ventricular diastolic dysfunction and cardiac sympathetic derangement in patients with Anderson-Fabry disease: a 2D speckle tracking echocardiography and cardiac 123I-MIBG studyP1107Left ventricular hypertrophy and mild cognitive impairment as markers for target organ damage in hypertensive patients with multiple risk factorsP1108Subclinical left ventricular dysfunction in asymptomatic type 1 diabetic childrenP1109Minimal differences shown by echocardiography and NT-proBNP level distinguishing cardiotoxic effect related to breast cancer therapy in patients with or without HER2 expression.P1110Speed of recovery of left ventricular function is not related to the prognosis of takotsubo cardiomyopathy - a portuguese multicenter studyP1111Myocardial dysfunction in Takotsubo cardiomyopathy - more than meets the eye?P1112Obstructive sleep apnea and echocardiographic parameters

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jew262.001 ◽

2016 ◽

Vol 17 (suppl 2) ◽

pp. ii227-ii234

Author(s):

I. El-Dosouky ◽

CL. Polte ◽

T. Okubo ◽

A. Gonzalez Gomez ◽

B. Liu ◽

...

Keyword(s):

Heart Failure ◽

Infective Endocarditis ◽

Aortic Valve ◽

Mitral Regurgitation ◽

Left Ventricular Function ◽

Transesophageal Echocardiography ◽

Ventricular Function ◽

Takotsubo Cardiomyopathy ◽

Left Ventricular

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Right-sided infective endocarditis

ESC CardioMed ◽

10.1093/med/9780198784906.003.0394 ◽

2018 ◽

pp. 1726-1728

Author(s):

José A. San Román ◽

Javier López

Keyword(s):

Heart Failure ◽

Staphylococcus Aureus ◽

Infective Endocarditis ◽

Diagnostic Yield ◽

Diuretic Therapy ◽

Clinical Manifestations ◽

Right Heart Failure ◽

Right Heart ◽

Duke Criteria ◽

Initial Imaging

Right-sided infective endocarditis (RSIE) can be classified into three epidemiological groups: intravenous drug users (IDUs), intravascular device carriers, and the ‘three noes’ group (no left-sided, no device, no IDUs). RSIE represents 5–10% of all infective endocarditis episodes in adults. The most common clinical manifestations of RSIE are fever and respiratory symptoms. The microbiological profile is dominated by Staphylococcus species, especially methicillin-sensitive Staphylococcus aureus. The modified Duke criteria should be used for the diagnosis of this entity, although their sensitivity and specificity are lower than in left-sided infective endocarditis. Regarding imaging in RSIE, the diagnostic yield of transthoracic echocardiography (TTE) is comparable with transoesophageal echocardiography, so TTE should be the initial imaging technique when RSIE is clinically suspected. The empirical antibiotic treatment should include antibiotics against staphylococci, such as vancomycin or daptomycin in combination with gentamicin and then adapted to the antibiogram. In non-complicated episodes of isolated tricuspid endocarditis caused by methicillin-sensitive Staphylococcus aureus, a 2-week regimen with cloxacillin can be safely used. In other cases, a standard 4–6 weeks is mandatory. Careful selection of patients for surgery is needed and surgery is only indicated in cases of microorganisms difficult to eradicate, or bacteraemia for more than 7 days despite adequate antimicrobial therapy, persistent tricuspid valve vegetations larger than 20 mm after recurrent pulmonary emboli with or without concomitant right heart failure, or right heart failure secondary to severe tricuspid regurgitation with poor response to diuretic therapy. Mortality of RSIE in IDUs is about 7%.

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Infective Endocarditis of the Aortic Valve with Anterior Mitral Valve Leaflet Aneurysm

Texas Heart Institute Journal ◽

10.14503/thij-15-5322 ◽

2016 ◽

Vol 43 (4) ◽

pp. 345-349 ◽

Cited By ~ 8

Author(s):

Anton Tomsic ◽

Wilson W.L. Li ◽

Marieke van Paridon ◽

Navin R. Bindraban ◽

Bas A.J.M. de Mol

Keyword(s):

Heart Failure ◽

Infective Endocarditis ◽

Mitral Valve ◽

Aortic Valve ◽

Mitral Regurgitation ◽

Antibiotic Therapy ◽

Medical Literature ◽

Severe Mitral Regurgitation ◽

Valve Leaflet ◽

Mitral Valve Leaflet

Mitral valve leaflet aneurysm is a rare and potentially devastating complication of aortic valve endocarditis. We report the case of a 48-year-old man who had endocarditis of the native aortic valve and a concomitant aneurysm of the anterior mitral valve leaflet. Severe mitral regurgitation occurred after the aneurysm perforated. The patient showed no signs of heart failure and completed a 6-week regimen of antibiotic therapy before undergoing successful aortic and mitral valve replacement. In addition to the patient's case, we review the relevant medical literature.

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163. Infective Endocarditis in Qatar: Risk Factors, Clinical Characteristics, Microbiology, and Outcomes

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.238 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S106-S107

Author(s):

Ahmed Zaqout ◽

Shaban Mohammed ◽

Maliha Thapur ◽

Hussam Al Soub ◽

Muna Almaslamani ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Infective Endocarditis ◽

Clinical Characteristics ◽

Surgical Intervention ◽

Skin Infections ◽

Cardiac Devices ◽

Duke Criteria ◽

Implantable Cardiac Devices ◽

Culture Negative

Abstract Background Infective endocarditis (IE) is a serious and life-threatening disease. The aim of the study is to describe the epidemiology, clinical characteristics and outcomes of patients with IE in Qatar. Methods Patients were identified from the electronic records of Hamad Medical Corporation hospitals, the national referral center for the State of Qatar. Those aged ≥18 years with Duke Criteria-based diagnosis of IE during the period from January 2015 to September 2017 were included. Data were analyzed using STATA software Version 15. Results Fifty-seven cases were included, of which 70% were males. Mean age was 51 years (± 16.8). Eleven (19%) were in association with prosthetic valves and 6 (11%) with implantable cardiac devices (Table 1). Fever (84%), dyspnea (46%) and heart failure were the commonest presentations. The majority of patients had preexisting valvular heart disease or intra-cardiac devices (Table 1). Skin infections (10, 18%) were the most prevalent portals of infection, followed by venous catheters, recent valve surgery and implantable cardiac devices (Table 1). Staphylococcus species were implicated in 19 (34%) and Streptococcaceae in 9 (16%); whereas 21 (37%) were culture-negative (Table 2). Left-side IE (49, 86%) was predominant. Acute kidney injury (AKI) (17, 30%) and heart failure (11, 19%) were common complications. The most frequently used treatment regimens included glycopeptides or Β-lactams (Table 2). Only 9 (16%) patients underwent surgical intervention. Fourteen (25%) patients died of any cause before hospital discharge. Logistic regression analysis identified septic shock and AKI as the only risk factors independently associated with in-hospital mortality (Table 3). Conclusion Skin infections are an important risk for IE in Qatar. The majority of patients with IE have preexisting cardiac conditions. Staphylococci are the commonest confirmed bacterial etiology of IE in Qatar, but nearly one-third of cases are culture-negative. Only a small proportion of patients with IE undergo surgical intervention and overall mortality is high. The findings suggest that efforts should be directed toward improving IE prevention strategies in high-risk patients, encourage early microbiological investigations and improved medical and surgical management. Disclosures All authors: No reported disclosures.

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Infective Endocarditis: A Case with Prolonged Fever

Cardiovascular and Cardiometabolic Journal (CCJ) ◽

10.20473/ccj.v2i2.2021.84-89 ◽

2021 ◽

Vol 2 (2) ◽

pp. 84

Author(s):

Maulia Prismadani ◽

Agus Subagjo

Keyword(s):

Infective Endocarditis ◽

Heart Valves ◽

High Rate ◽

Structural Abnormality ◽

Severe Mitral Regurgitation ◽

Mortality And Morbidity ◽

Prolonged Fever ◽

Duke Criteria ◽

History Of ◽

Major Criterion

Infective endocarditis (IE) is associated with a high rate of mortality and morbidity in patients with anomalies of heart valves. We present a case of a 23-year-old male known to have severe mitral regurgitation (MR) with a history of prolonged fever for 5 months. According to The Modified Duke Criteria, clinical sign and symptoms fulfilled one major criterion (echocardiography finding of vegetation on mitral valve) and three minor (fever of at least 380 Celsius, valvular heart disease as a predisposing heart condition, and positive blood culture for Lactococcus sp. and Pediococcus sp.) considered as definite IE. Fever is one of the most common symptoms of IE (>90% of cases). Patient with prolonged fever and structural abnormality of heart valve should be considered for acute or subacute of IE. Establishing an diagnosis of IE and appropriate antibiotic therapy will improve the patient's clinical condition, and reduce morbidity and mortality.

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Prevention and Management of Infective Endocarditis

Journal of Pharmacy Practice ◽

10.1177/089719009100400503 ◽

1991 ◽

Vol 4 (5) ◽

pp. 295-313

Author(s):

Julie McMorrow ◽

Milap C. Nahata

Keyword(s):

Infective Endocarditis ◽

Heart Valves ◽

Hospital Admissions ◽

Pediatric Hospital ◽

Invasive Procedures ◽

Congenital Cardiac Defects ◽

Septal Defects ◽

Endocardial Surface ◽

Diagnosis Therapy ◽

Heart Wall

Infective endocarditis is an infection of the endocardial surface of the heart and usually involves one or more heart valves but may occur on septal defects or the heart wall. Its incidence is approximately 1 per 1,000 adults and 0.5 per 1,000 pediatric hospital admissions. Factors predisposing to infective endocarditis include degenerative heart disease, survivable congenital cardiac defects, use of invasive procedures, chronic immunosuppression, and intravenous drug abuse. This article discusses the pathophysiology, diagnosis, therapy, and prevention of infective endocarditis.

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Clinical Features and Outcome of Infective Endocarditis in a University Hospital in Romania

Medicina ◽

10.3390/medicina57020158 ◽

2021 ◽

Vol 57 (2) ◽

pp. 158

Author(s):

Emilia Elena Babeș ◽

Diana Anca Lucuța ◽

Codruța Diana Petcheși ◽

Andreea Atena Zaha ◽

Cristian Ilyes ◽

...

Keyword(s):

Heart Failure ◽

Staphylococcus Aureus ◽

Infective Endocarditis ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

University Hospital ◽

Hospital Death ◽

Coagulase Negative Staphylococcus ◽

Index Number ◽

Duke Criteria

Background and Objectives: Characterization of patients with endocarditis regarding demographic, clinical, biological and imagistic data, blood culture results and possible correlation between different etiologic factors and host status characteristics. Material and methods: This is a retrospective observational descriptive study conducted on patients older than 18 years admitted in the past 10 years, in the Cardiology Clinic of the Clinical County Emergency Hospital Oradea Romania, with clinical suspicion of bacterial endocarditis. Demographic data, clinical, paraclinical investigations and outcome were registered and analyzed. Results: 92 patients with definite infective endocarditis (IE) according to modified Duke criteria were included. The mean age of patients was 63.80 ± 13.45 years. A percent of 32.6% had health care associated invasive procedure performed in the 6 months before diagnosis of endocarditis. Charlson’s comorbidity index number was 3.53 ± 2.029. Most common clinical symptoms and signs were: shortness of breath, cardiac murmur, fever. Sixty-six patients had native valve endocarditis, 26 patients had prosthetic valve endocarditis and one patient was with congenital heart disease. Blood cultures were positive in 61 patients. Among positive culture patient’s staphylococcus group was the most frequently involved: Staphylococcus aureus (19.6%) and coagulase negative Staphylococcus (18.5%). Most frequent complications were heart failure, acute renal failure and embolic events. Conclusions: Staphylococcus aureus IE was associated with the presence of large vegetations, prosthetic valve endocarditis and intracardiac abscess. Coagulase negative Staphylococcus (CoNS) infection was associated with prosthetic valve dysfunction. Streptococcus gallolyticus etiology correlated with ischemic embolic stroke and the presence of large vegetations. Cardiovascular surgery was recommended in 67.4% of patients but was performed only on half of them. In hospital death occurred in 33.7% of patients and independent predictors of mortality were congestive heart failure and septic shock.

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Changes of heart geometry in patients with ischemic heart disease

Medicina ◽

10.3390/medicina44010002 ◽

2007 ◽

Vol 44 (1) ◽

pp. 8 ◽

Cited By ~ 2

Author(s):

Dalia Pangonytė ◽

Elena Stalioraitytė ◽

Danutė Kazlauskaitė ◽

Reda Žiuraitienė ◽

Zita Stanionienė ◽

...

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Surface Area ◽

Clinical Symptoms ◽

Left Ventricular ◽

Ischemic Heart ◽

Proportional Increase ◽

Endocardial Surface ◽

Acute Event

Objective. The aim of the study was to determine ventricular and atrial cardiometric parameters at preinfarction and postinfarction stage of ischemic heart disease. Object and methods. Cardiometric parameters (mass, endocardial surface area, the tracts of flow and outflow, etc.) of 132 men (mean age of 49.7±8.9 years) who had died suddenly during prehospital period (within 6 hours) after the first or repeated acute event of “pure” ischemic heart disease were investigated. These patients had no other, except ischemia, factors predisposing myocardial hypertrophy as well as clinical symptoms of heart failure. The decedents were divided into preinfarction (71 men) and postinfarction ischemic heart disease (61 men) groups. Results. At preinfarction stage of ischemic heart disease, mass and endocardial surface area of all parts of the heart were increased, the tracts of flow and outflow – longer. At postinfarction stage, only corresponding left ventricular and atrial parameters were more increased. Conclusions. Eccentric type of left ventricular hypertrophy (proportional increase of mass and endocardial surface area) and concentric type of right ventricular and right and left atrial hypertrophy (the part of myocardium mass per unit of endocardial area is greater) were determined at preinfarction stage of ischemic heart disease. At postinfarction stage, at least as far as evidence of heart failure is not overt, only the corresponding left ventricular and atrial hypertrophy progresses.

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