[Clinical and hematological findings in affected dairy cows with combined tricuspid and mural endocarditis]

Endocarditis of cattle can develop as valvular, mural or concurrent involvement of the valvular and mural endocardium. Given the importance of endocarditis among the diseases of the cardiovascular system in cattle, 568 dairy cows were studied through complete clinical examination, looking particularly for special signs of heart involvement. The cows suspected of having a heart problem were labeled following the identification. Additional measures including blood sampling, carcass examination, and lesion sampling for histopathology were carried out in the abattoir, and endocarditis was diagnosed in 2.81% of the cases. The mean age of the cows with endocarditis was 5.4 years. The body temperature was higher than 39[degree sign]C in 56.2% of the cases. Almost 70% of the cows had more than 84 heart beats per minute. Acardiac systolic murmur was found in 56.2% of the cows. Fewer than 5,500 white blood cells per microliter and neutrophilia with more than 40% neutrophils was diagnosed in 75% and 50% of the cases, respectively. Given these results, it was concluded that despite the absence of audible systolic murmur using a stethoscope, it is probable to see valvular endocarditis, particularly in industrial mid-aged dairy cows with a focal active infective involvement showing mild fever, persistent high or at least relatively high heart beat rate and intensity, marginal leucopenia, and relatively increased neutrophils and monocytes. Therefore it may be suitable to conduct echocardiography due to its very applicable findings

Pacemaker lead thrombo-endocarditis in an intravenous drug abuser

We report a 30-year-old male intravenous drug abuser presenting with persistent pacemaker lead thrombosis with superimposed pacemaker lead endocarditis. He underwent urgent surgery, but expired due to refractory sepsis. This case confirms that patients with pacemakers are at risk of developing pacemaker lead thrombosis. In addition, they are at high risk of developing pacemaker lead endocarditis if additional risk factors for endocarditis are present. We believe this case report is unusual on account of pacemaker lead thrombosis as well as endocarditis occurring in a patient with history of intravenous drug abuse. Whether pacemaker patients with multiple leads need to be on long-term antiplatelet or anticoagulation therapy necessitates further studies

relation between noneacterial thrombotic endocarditis and thromboembolism in patients with cancer

Patients with cancer are in hypercoagulable state. Nonbacterial thrombotic endocarditis [NBTE] can complicate any cancer. The major clinical manifestations of NBTE result from systemic emboli rather than valvular dysfunction. To assess the frequency and echocardiographic characteristics and to determine whether the presence of valvular lesions correlate with thrombo-embolic manifestations [TEM]. A prospective study conducted on 60 patients with different histopathological types of cancer and 10 healthy volunteers. A full medical history taking and physical examination were done and according to the performance status using the WHO score, the patients were classified into two groups of patients; group one, patients with good performance [grade I and II] and group two those with poor performance [III and IV]. Doppler echocardiography, chest-x-ray, abdominal sonography, and laboratory study including complete blood count [CBC]; bleeding time [BT]; prothrombin time and concentration [PT and PC]; Activated partial thromboplastin time [APTT] and serum level of both fibrinogen and D-dimer were done for all participants. Blood culture was done only for patients with NBTE. Doppler study of extremities and computed tomography [CT] of the brain were done for suspected patients with deep venous thrombosis [DVT] and cerebrovascular [CV] stroke respectively, NBTE was detected in 16 out of 60 patients [26.66%]. 22valve lesions were found; the aortic and mitral valves were the commonest sites [12 and 7 lesions respectively]. Valvular regurgitation was found in 12/60 patients [20%]; tricuspid regurgitation [TR] was the commonest lesion [42%]. The incidence of NBTE was higher in patients with poor performance than in those with good performance [p<0.001], and the highest incidence was in patients with adenocarcinoma of pancreas [50%]. Serum level of D-dimer ms higher in patients with NBTE than in those without NBTE [p<0.001]. The incidence of TEM was higher in patients with NBTE than in those without [62.5% versus 6.8%, p<0.001]. NBTE is not uncommon in patients with cancer. Aortic valve was the most commonly affected. Adenocarcinoma was the most frequent histologic type of related cancer. The major clinical manifestations of NBTE result from systemic emboli rather than valvular dysfunction. NBTE should be suspected in any stroke patient with a known or suspected malignancy and anticoagulation with unfractionated or low molecular weight heparin should be used in cancer patients with NBTE

Endocardite infecciosa em valva nativa / Infective endocarditis at native valve

A endocardite é uma das doenças de mais rica propedêutica na cardiologia. Desde a primeira descrição de um quadro clínico sugestivo de endocardite infecciosa, em 1646, por Lazare Reviere, muitas mudanças ocorreram, com progressiva sistematização de diagnóstico e terapêutica. Após mais de 200 anos...

Endocardite por staphylococcus aureus em valva aórtica bivalvular, associado à membrana subaórtica e embolia cerebral / Endocarditis by Staphylococcus aureus in aortic valve bivalvular, association in subaortic membrane

Paciente jovem, portador de valva aórtica bicúspidee membrana subaórtica que foi acometido porendocardite por staphylococcus em valva, fezmúltiplos acidentes vasculares encefálicosembólicos, tendo evoluído para o óbito

Rheumatic heart disease in the past decade: an autopsy analysis.

BACKGROUND: Rheumatic heart disease continues to be an important cardiac problem, afflicting the young population of India. Though prophylaxis and various treatment modalities are available for the valvar pathology, mortality and morbidity continue to be high. Autopsy data are scarce. METHODS AND RESULTS: This is an autopsy analysis of rheumatic heart disease as seen at a large teaching hospital over a period of 5 years in the past decade. Four hundred thirty-four cases were autopsied in a five-year period from 1993 to 1997. The majority of cases were between 16 and 40 years of age. Fifty cases showed the presence of Aschoff bodies indicating a recent attack of rheumatic carditis. One hundred seventy-eight valves were examined in detail--in 174, the mitral valve was involved. In 4 cases, only the aortic valve was affected. The mitral valve showed significant disease with a severe degree of subvalvar pathology. One hundred thirty-eight patients had already undergone some form of previous surgery and presented with valve dysfunction. Most of these patients were in the third and fourth decades of life. The most frequent cause of death in operated and unoperated cases was congestive cardiac failure. CONCLUSIONS: There is no decrease in the incidence or severity of rheumatic heart disease over a period of 25 years as seen at our institute. The pattern of the disease has changed, with patients who had a previous surgery now returning with valve dysfunction or related problems.

Endocarditis infecciosa en el Hospital Vargas de Caracas / Indective endocarditis diagnosis in the Hospital Vargas of Caracas

Se estudiaron en forma retrospectiva las historias clínicas de 64 pacientes que cunplían con los criterios diagnósticos de endocarditis infecciosa (EI) en el Hospital Vargas de Caracas entre enero de 1990 y diciembre de 1995. Se analizó la casuística en base a diagnóstico definitivo o probable de EI, sexo, edad, signos y síntomas más frecuentes, factores predisponentes, hallazgos microbiológicos, ecocardiográficos, evolución clínica, complicaciones y mortalidad durante su hospitalización. De acuerdo al análisis de los resultados, la endocarditis infecciosa no es una patología despreciable en nuestro medio, presentándose la mayoría de los casos entre la segunda y cuarta década de vida en pacientes en su mayoría con valvulopatias subyacentes, con un predominio de Gram positivos como agente causal y una mortalidad superior a la reportada en otras series internacionales, principalmente por complicaciones cardíacas

Fibrolamellar carcinoma of the liver--an unusual presentation.

Non-bacterial thrombotic endocarditis was found at autopsy in a 17 year old male patient of fibrolamellar type of hepatocellular carcinoma with pericardial metastases. This had resulted in multiple embolic cerebral infarcts with long standing hemiplegia and later death due to acute left ventricular failure.

Endocarditis infecciosa por candida: presentación de 3 casos y revisión de la literatura / Infective endocarditis due to candida: presentation of 3 cases and literature review

Se revisan 3 casos de endocarditis infecciosa por Candida sp en individuos sin inmunodeficiencia pero sometidos a cirugía mayor, uso prolongado de antimicrobianos e implantes de material protésico. Se analizan los dificultades en el diagnóstico y el tratamiento

Fibroelastosis endocárdica: aspectos clínicos y ecocardiográfico / Endocardial fibroelastosis: clinical and echocardiographic aspects

Se presentan los hallazgos clínicos de 17 pacientes portadores de fribroelastosis endocárdica (FEE), 10 con estudio ecocardiográfico seriado y comprobación necrópsica en 8. A los signos ecocardigráficos de la miocardiopatía congestiva, en el ecocardiograma Modo-M de estos pacientes se constató un nítido engrosamiento del endocardio y del aparato subvalvular: en un caso, el engrosamiento progresó claramente hasta el fallecimiento. Los hallazgos histológicos sugieren que la enfermedad puede evolucionar en brotes, con engrosamiento fibroelástico progresivo del endocardio. La letalidad en el corto plazo fue cercana a 50%. Pero la evolución depende en gran medida de la precocidad, intensidad y constancia del tratamiento. El uso de vasodilatadores parece mejorar el pronóstico y la sobrevida