RESUMO
A partir de 196 cas d'arythmies supraventriculaires colliges en 5 ans parmi 4269 malades hospitalises; les auteurs ont determine leur frequence et ont analyse les etiologies. La fibrillation auriculaire etait l'arythmie supraventriculaire la plus frequente (156 cas: 79;6 pour cent); suivie du flutter auriculaire (17 cas: 8;7 pour cent); la tachysystolie auriculaire (13 cas: 6;6 pour cent); et la tachycardie jonctionnelle (10 cas: 5;1 pour cent). Dans 188 cas (95;7 pour cent); une cause organique cardiaque a ete identifiee. Il s'agissait d'une cardiopathie arterielle (81 cas); d'une valvulopathie (68 cas); d'une myocardiopathie (22 cas); de cardiopathies diverses (15 cas); de cardiothyreose (2 cas). Dans 3 cas il s'agissait d'une cause extracardiaque et dans 5 cas d'arythmies supraventriculaires idiopathiques. Devant une arythmie supraventriculaire; il parait primordial de rechercher une cardiopathie sous-jacente de facon a traiter l'une et l'autre. Les auteurs soulignent l'interet d'un equipement en moyens adequats de diagnostic et de surveillance rythmologique
Assuntos
Arritmias Cardíacas , Taquicardia , Fibrilação VentricularRESUMO
With the object of analyzing current characteristics of post-partum and post-abortum infective endocarditis (IE), authors carried out a retrospective study of 15 cases between september 1985 and may 1992. Mean age was 22.2 +/- 4.0 years. Origin of sepsis was delivery (1 case), abortion (14 cases). There was no underlying cardiac lesion in 9 cases, rheumatic heart disease in 6 cases. Infecting organisms were Staphylococcus aureus (n = 6), streptococcus D (n = 3), Clostridium perfringens (n = 2). There were 10 acute and 5 subacute IE, 7 right-sided, 7 left-sided, and 1 right and left-sided IE. Vegetations were determined by transthoracic echocardiography in 12 cases (80%). The main complications were heart failure (15 cases), and pulmonary or arterial embolism (7 cases). Lethality was 53.3% and was not different in tricuspid acute IE and left-sided IE. Treatment was the more difficult as cardiac surgery is expensive or even inaccessible. Accordingly, prevention is primordial. It consist of antibiotic prophylaxis and fight against illicit abortion.
Assuntos
Aborto Induzido/efeitos adversos , Parto Obstétrico/efeitos adversos , Endocardite Bacteriana/etiologia , Adolescente , Adulto , Baixo Débito Cardíaco/etiologia , Infecções por Clostridium , Clostridium perfringens , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana Subaguda/diagnóstico por imagem , Endocardite Bacteriana Subaguda/etiologia , Feminino , Doenças das Valvas Cardíacas/complicações , Humanos , Gravidez , Cardiopatia Reumática/complicações , Infecções Estafilocócicas , Infecções Estreptocócicas , Taxa de Sobrevida , UltrassonografiaRESUMO
The aim of this study was to report the authors' experience of infective endocarditis (IE) from 47 cases collected between 1976 to 1991. Infective endocarditis (IE) was documented with surgical (n = 9), microbiological (n = 26), and echocardiographic (n = 30) criteria. There were 11 male, 36 female: mean age, 26.2 +/- 10.3 years (extremes: 17 and 47). The authors noted a great importance of gynecological portal entry (13 cases), acute infective endocarditis (23 cases i.e. 48.9%), heart failure (39 cases i.e. 82.9%), and pulmonary (4 cases i.e. 8.5%) and systemic (8 cases i.e. 17.0% embolism. Surgical treatment was impossible in Brazzaville. Trans-thoracic echocardiography was performed in 38 cases and revealed vegetations in 30 cases i.e. 78.9%. Twenty patients died (42.5%) because heart failure. There was no significant difference in letality between infective endocarditis treated surgically or no, between native valve or prosthetic valve infective endocarditis, between culture negative or culture positive infective endocarditis (IE). This study corroborate that infective endocarditis is a heavy illness, characterized by high frequency of heart failure. The authors insist upon the prevention of infective endocarditis.
