scholarly journals Infective endocarditis or myxoma? Description of a patient with new diagnosis of congestive heart failure

2015 ◽  
Vol 78 (2) ◽  
Author(s):  
Marzia Testa ◽  
Enrico Lombardo ◽  
Enrico Avogadri ◽  
Marco Agostini ◽  
Giuseppe Forte ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Infective Endocarditis ◽  
Inflammatory Disease ◽  
Diagnostic Tool ◽  
Heart Valves ◽  
New Diagnosis

ABSTRACT: Infective endocarditis (IE) is an inflammatory disease which interests heart endothelium and mostly heart valves. IE is not a uniform disease, but presents in a variety of different forms that makes the diagnosis difficult. Echocardiography is a crucial diagnostic tool for the diagnosis, especially in those patients who have no typical symptoms as in the case here presented, in which the possibility of a myxoma was also considered.

Early Surgical Intervention for Infective Endocarditis

2002 ◽  
Vol 10 (4) ◽  
pp. 298-301 ◽  
Author(s):  
Hong Sheng Zhu ◽  
Pei Yan Yao ◽  
Jia Hao Zheng ◽  
A Thomas Pezzella
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Complex Disease ◽  
Surgical Intervention ◽  
Elective Surgery ◽  
Postoperative Bleeding ◽  
Arterial Embolization ◽  
Early Surgical Intervention

Infective endocarditis remains a serious and complex disease with significant morbidity and mortality. Sixty cases of infective endocarditis were retrospectively reviewed, consisting of 41 males and 19 females aged 7 to 50 years (mean, 30 years). Congenital heart disease was diagnosed in 19 of the patients and rheumatic heart disease in 41. Congestive heart failure occurred in 36 and systemic embolism in 8 cases. Blood cultures were positive in only 21.7% of the cases, while vegetations were detected by 2-dimensional echocardiography in 70%. Elective surgery was performed in 57 patients and emergent operation for systemic arterial embolization and/or intractable congestive heart failure in 3 patients. Two patients required reoperation for postoperative bleeding. All but 2 patients had been followed up for 6 to 160 months with no evidence of reinfection. Three patients with mechanical valve implantation later died of intracranial bleeding due to over-anticoagulation. The remaining 55 resumed normal activity. The encouraging outcomes were the result of an aggressive diagnostic approach and early surgical intervention.

scholarly journals Infective Endocarditis Complicated with Progressive Heart Failure due to β-Lactamase-Producing Cardiobacterium hominis

2000 ◽  
Vol 38 (5) ◽  
pp. 2015-2017 ◽  
Author(s):  
Po-Liang Lu ◽  
Po-Ren Hsueh ◽  
Chien-Ching Hung ◽  
Lee-Jene Teng ◽  
Tsrang-Neng Jang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Blood Isolate ◽  
Severe Aortic Regurgitation ◽  
Progressive Heart Failure ◽  
Resistance To Penicillin ◽  
High Level ◽  
Level Resistance

We describe a 66-year-old woman with infective endocarditis due toCardiobacterium hominis whose condition, complicated by severe aortic regurgitation and congestive heart failure, necessitated aortic valve replacement despite treatment with ceftriaxone followed by ciprofloxacin. The blood isolate of C. hominis produced β-lactamase and exhibited high-level resistance to penicillin (MIC, ≧256 μg/ml) and reduced susceptibility to vancomycin (MIC, 8 μg/ml).

scholarly journals Dressler’s like pericarditis with pericardial effusion is the presenting feature of infective endocarditis

2018 ◽  
Vol 15 (1) ◽  
pp. 43-44
Author(s):  
Biswajit Majumder ◽  
Sharmistha Chatterjee ◽  
Rakesh Sarkar ◽  
Pritam Kumar Chatterjee
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Renal Failure ◽  
Infective Endocarditis ◽  
Pericardial Effusion ◽  
Aortic Valve ◽  
Medical Therapy ◽  
Surgical Intervention ◽  
Autoimmune Reaction ◽  
Pericardial Involvement

Summary: Infective Endocarditis (IE) being primarily the disease of valves and endocardium may occasionally be complicated with pericardial involvement in the form of pericarditis and pericardial effusion (PE). Pericarditis may be observed incidentally at the time of diagnosing IE and rarely does it remain the presenting feature of IE .The pericardial effusion may be attributed to ruptured aortic abscess extending into the pericardial space, autoimmune reaction, renal failure, HIV and congestive heart failure (CHF). Here we are presenting a 42 year old male having IE with vegetation in both mitral and aortic valve along with large sterile pericardial effusion was treated successfully by the medical therapy alone with favorable outcome. IE presenting with large exudative pericardial effusion being treated without any surgical intervention with substantial resolution of effusion has not been reported so far in medical literature.Nepalese Heart Journal 2017;12(2): 43-44.

Trends in Infective Endocarditis Complicated by Congestive Heart Failure: Data From the National Inpatient Sample From 1999-2014

CHEST Journal ◽  
2017 ◽  
Vol 152 (4) ◽  
pp. A65 ◽  
Author(s):  
Prateeth Pati ◽  
Adnan Khalif ◽  
Balaji Shanmugam ◽  
Stuthi Perimbeti ◽  
John Ward
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Infective Endocarditis ◽  
National Inpatient Sample ◽  
Failure Data

Cancer and Infective endocarditis: diagnosis and prognostic impact. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Cosyns ◽  
B Roosens ◽  
P Lancellotti ◽  
S Marchetta ◽  
V Scheggi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Surgery ◽  
Infective Endocarditis ◽  
Cancer Patients ◽  
Prospective Cohort ◽  
Funding Source ◽  
Prognostic Impact ◽  
Private Company ◽  
Prevalence Of Cancer

Abstract Background Little is known about the characteristics of infectious endocarditis (IE) in cancer patients, although their risk may be higher and their presentation non-specific. Purpose This study sought to assess the prevalence of cancer in patients with IE in the EURO-ENDO registry and to determine their baseline characteristics, management, outcomes in comparison to cancer-free patients with IE. Methods Data were collected from a prospective cohort of 3085 adult patients enrolled in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on the ESC 2015 diagnostic criteria. Clinical, biological, microbiological and echocardiographic findings, use of other imaging techniques, medical therapy, complications, theoretical indications for surgery, in-hospital mortality, and 1-year mortality were analysed in IE patients with and without cancer. Results 359 (11.6%) cancer patients with IE were identified and compared with 2726 IE patients without cancer. IE was community-acquired in 225/361 (74.8%), and more often nosocomial (18.6%) in healthcare associated cases. IE was native in 209 (60.4%), prosthetic in 97 (28%) and device-related in 30 (8.7%) patients. Microorganisms involved were Enterococci in 72/303 (23.8%), methicillin-sensitive Staphylococci in 63/303 (20.8%), and Streptococcus gallolyticus in 33/303 (10.9%) patients. IE cancer patients received more long-term cortico-therapy and immunosuppressive treatment compared to cancer free IE patients (9.1% vs. 3.9%, P<0.0001 and 11.7% vs. 2.7%, P<0.0001, respectively). Acute renal failure was the most frequent complication, observed in 25.9% of patients, followed by embolic events (21.7%). Congestive heart failure and cardiogenic shock occurred more frequently in cancer patients (18.1% vs. 13.4%, P=0.016; 10.1% vs. 6.3%, P=0.011, respectively). Cancer IE patients were more frequently treated with amoxicillin (35.8% vs. 26.3%; P=0.0002) and daptomycin (15.2% vs. 10.6%; P=0.0096), but less frequently treated with vancomycin (34.6% vs. 44.9%, P=0.0003). According to the ESC guidelines, theoretical indication for cardiac surgery was not significantly different between groups (65.5% vs. 69.8%, P=0.091), but was effectively less performed when indicated in cancer IE patients during hospitalisation (65.5% vs. 75.0%, P=0.0018). Compared to cancer-free IE patients, in-hospital and 1-year death occurred in 23.4% vs. 16.1%, P=0.006, and 35.7% vs. 23.1%, P<0.001, respectively. Predictors of mortality by multivariate analysis were creatinine >2 mg/dL, congestive heart failure and unperformed cardiac surgery (when indicated). Conclusion We report the largest contemporary series of patients with IE and cancer. The prevalence of cancer in IE patients is common and associated with a worse outcome. Patients with IE and cancer have different clinical characteristics than the general population and should require a specific management. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Pharmacological.

scholarly journals Predictors of mortality in patients with right-side and cardiac device-related infective endocarditis, the esc-eorp euro-endo registry

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Sambola ◽  
J Lozano Torres ◽  
C Olmos ◽  
J Ternacle ◽  
F E Calvo-Iglesias ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Univariable Analysis ◽  
Cardiac Device ◽  
Ventricular Ejection Fraction ◽  
Factors Associated

Abstract Background/Introduction Mortality in right-sided infective endocarditis (RSIE) and cardiac device-related IE (CDRIE) rates have increased mainly due derived complications and heterogeneity of the disease. A better understanding of associated risk factors to mortality in these entities are required in order to develop an efficient therapy. Purpose The aim of this study was to assess 30-day mortality rate and variables associated in RSIE and CDRIE. Methods The ESC-EORP EURO-ENDO registry is a prospective multicenter observational study of patients presenting with definite or possible IE in Europe and ESC-affiliated/non-affiliated countries. Patients were included from January 2016 to 31 March 2018 in 156 centers from 40 countries. Clinical data, blood test analysis and multi-modality imaging tests (echocardiography, computed tomography, PET-CT, magnetic resonance) were collected. Primary endpoint was 30-day mortality. Univariable analysis was performed to assess variables associated with 30-day mortality. Results Among 269 patients with RSIE, 24 patients (9.8%) died during the first 30-day of IE diagnosis. Cut-off value for best vegetation size related to 30-day mortality was vegetation length >19mm, with a HR = 2.88 (95% CI 1.26–6.58, p=0.01) and a Harrell's Concordance of 0.632. Factors associated with 30-days mortality by univariable analysis were: vegetation size >19mm (OR = 2.99, 95% CI [1.31–6.84], p=0.009), previous stroke or transient ischemic attack (OR = 5.10, 95% CI [1.19–21.88], p=0.029), HIV infection (OR = 3.52, 95% CI [1.03–12.10], p=0.046), chronic renal failure (OR = 2.66, 95% CI [1.06–6.71], p=0.038), congestive heart failure at admission (OR = 2.34, 95% CI [1.00–5.47], p=0.050) and severe regurgitation (OR = 3.77, 95% CI [1.56–9.09], p=0.003). On the other side, among the 227 patients with CDRIE, 24 patients (8.8%) died during the first 30-day of IE diagnosis. Factors associated with an increase in 30-day mortality by univariate analysis were: age per 10 years (OR = 1.49, 95% CI [1.02–2.18], p=0.039), heart failure history (OR = 3.88, 95% CI [1.39–10.80], p=0.009), congestive heart failure on admission (OR = 5.80, 95% CI [2.31–14.55], p<0.001) and cardiogenic shock on admission (OR = 13.37, 95% CI [3.75–47.64], p<0.001). An increase in left ventricular ejection fraction (LVEF) per 10% was a protective factor (OR = 0.66, 95% CI [0.49–0.90], p=0.008). Conclusions Patients with RSIE and CDRIE had a not negligible 30-day mortality rate (9.8% and 8.8%, respectively). Factors associated with RSIE and CDRIE mortality are different; while in the right side location, the mortality was related with vegetation size and comorbidities, in the case of CDRIE, the mortality was mainly associated to the presence of heart failure. FUNDunding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Euro-Endo registry by European Society of Cardiology

Infective Endocarditis

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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