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1.
Arq. bras. cardiol ; 120(3): e20220608, 2023. tab, graf
Article Dans Portugais | LILACS-Express | LILACS | ID: biblio-1420200

Résumé

Resumo Fundamento A endocardite infecciosa (EI) refere-se à infecção da superfície endocárdica do coração e geralmente ocorre em valvas nativas ou protéticas. Objetivo Este estudo teve como objetivo levantar dados de EI refletindo a terapêutica cirúrgica, em um Hospital Universitário do interior do estado de São Paulo - Brasil. Método Abordagem retrospectiva e observacional de 328 pacientes com EI operados entre 1982 e 2020 Resultados Os principais dados (n=121/37%), insuficiência cardíaca congestiva (n=114/35%), valvopatia (n=92/28%), diabetes mellitus (n=85/26%), doença renal crônica (n=59/18%) e febre reumática (49/15%). A insuficiência renal é um dos principais e mais relevantes fatores de risco pré-cirúrgicos para um mau prognóstico. Conclusão Para um melhor resultado clínico e cirúrgico é necessário o diagnóstico sindrômico e etiológico precoce da EI, principalmente em pacientes com múltiplas comorbidades.


Abstract Background Infectious endocarditis (IE) refers to infection of the endocardial surface of the heart and usually occurs in native or prosthetic valves. Objective This study aimed to raise IE data reflecting the surgical therapy in a University Hospital in the interior of the State of Sao Paulo-Brazil. Method Retrospective and observational approach of 328 patients with IE who underwent surgery between 1982 and 2020 Results The main data (n=121/37%), congestive heart failure (n=114/35%), valve disease (n=92/28%), diabetes mellitus (n=85/26%), chronic kidney disease (n=59/18%), and rheumatic fever (49/15%). Renal failure is one of the main and most relevant pre-surgical risk factors for a poor prognosis. Conclusion For a better clinical and surgical outcome, an early syndromic and etiological diagnosis of IE is necessary, especially in patients with multiple comorbidities.

2.
Autops. Case Rep ; 11: e2021269, 2021. graf
Article Dans Anglais | LILACS | ID: biblio-1249004

Résumé

Rheumatic heart disease is still common in developing countries and requires prompt intervention to prevent chronic complications. Vegetations in rheumatic heart disease might be due to acute episodes of rheumatic fever itself or due to either infective endocarditis (IE) or Non-infectious thrombotic endocarditis (NITE). Each form of vegetations has specific pathological characteristics on gross and microscopic examination. However, clinically IE and NITE may have overlapping signs and symptoms. A chance of misdiagnosis of NITE as culture-negative infective endocarditis is higher if the former present with infective symptoms like fever. NITE of valves can be due to underlying associated malignant neoplasm, particularly mucinous adenocarcinoma, pneumonia, cirrhosis, autoimmune disorders, and hypercoagulable state. The coexistence of tuberculosis, non-infectious thrombotic endocarditis and rheumatic valvular heart disease was rarely documented in medical literature. We describe a case of chronic rheumatic heart disease with vegetations in the posterior mitral valve leaflet, treated as culture-negative infective endocarditis, which, at autopsy, reveals the presence of Nonbacterial thrombotic endocarditis vegetation over calcified, fibrosed mitral valve leaflets and associated disseminated tuberculosis along with classic pathological sequela findings of chronic rheumatic mitral valvular heart disease in lungs and liver.


Sujets)
Humains , Mâle , Adulte , Rhumatisme cardiaque , Tuberculose , Endocardite non infectieuse/anatomopathologie , Autopsie , Issue fatale , Diagnostic différentiel
4.
Korean Circulation Journal ; : 425-428, 2016.
Article Dans Anglais | WPRIM | ID: wpr-43720

Résumé

Rheumatoid arthritis (RA) is frequently associated with various extra-joint complications. Although rare, thromboembolic complications are associated with high morbidity and mortality. We experienced a very rare case of nonbacterial thrombotic endocarditis (NBTE) and subsequent embolic stroke in a patient with RA. A 72-year-old male with a 15-year history of RA suddenly developed neurologic symptoms of vomiting and dizziness. Brain magnetic resonance imaging revealed recently developed multiple cerebellar and cerebral lacunar infarctions. Echocardiography showed a pulsating mitral valve vegetation involving the posterior cusp of the mitral valve leaflet, which was confirmed as NBTE. Immediate anti-coagulation therapy was started. The NBTE lesion disappeared in follow-up echocardiography after 4 weeks of anti-coagulation treatment.


Sujets)
Sujet âgé , Humains , Mâle , Polyarthrite rhumatoïde , Encéphale , Sensation vertigineuse , Échocardiographie , Endocardite , Endocardite non infectieuse , Études de suivi , Imagerie par résonance magnétique , Valve atrioventriculaire gauche , Mortalité , Manifestations neurologiques , Accident vasculaire cérébral , Accident vasculaire cérébral lacunaire , Vomissement
5.
Tuberculosis and Respiratory Diseases ; : 34-37, 2014.
Article Dans Anglais | WPRIM | ID: wpr-144977

Résumé

Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.


Sujets)
Femelle , Humains , Adénocarcinome , Carcinome pulmonaire non à petites cellules , Endocardite , Endocardite non infectieuse , Défaillance cardiaque , Infarctus , Poumon , Tumeurs du poumon , Thrombophilie , Thrombose veineuse
6.
Tuberculosis and Respiratory Diseases ; : 34-37, 2014.
Article Dans Anglais | WPRIM | ID: wpr-144964

Résumé

Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.


Sujets)
Femelle , Humains , Adénocarcinome , Carcinome pulmonaire non à petites cellules , Endocardite , Endocardite non infectieuse , Défaillance cardiaque , Infarctus , Poumon , Tumeurs du poumon , Thrombophilie , Thrombose veineuse
7.
Korean Circulation Journal ; : 189-192, 2014.
Article Dans Anglais | WPRIM | ID: wpr-59985

Résumé

Ante mortem cases of venous thrombosis in patients with nonbacterial thrombotic endocarditis (NBTE) have not yet been reported. We describe a rare case of NBTE in a patient with mesenteric vein thrombosis. A healthy 37-year-old man with abdominal pain and fever underwent emergency small bowel resection due to bowel ischemia resulting from mesenteric vein thrombosis. Transthoracic echocardiography revealed multiple mobile masses attached to the anterior leaflet of the mitral valves and their chordae tendineae. On suspicion of infective endocarditis, the cardiac masses were excised through open-heart surgery. However, pathologic reviews were compatible with NBTE. The patient was stable after the cardiac surgery and was treated with warfarin. Laboratory and imaging findings regarding his hypercoagulable condition were all negative.


Sujets)
Adulte , Humains , Douleur abdominale , Fourmis , Cordages tendineux , Échocardiographie , Urgences , Endocardite , Endocardite non infectieuse , Fièvre , Infarctus , Ischémie , Veines mésentériques , Valve atrioventriculaire gauche , Chirurgie thoracique , Thrombose , Thrombose veineuse , Warfarine
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