[Infective endocarditis: clinical aspects and necropsy study in 20 cases]. / Endocarditis infecciosa: aspectos clínicos y estudio necropsico en 20 casos.

Aiming to know the principal anatomo-pathological findings in patients that died with a diagnosis of infective endocarditis, the clinical histories and necropsy protocols of such patients that died between 1984 and 1989 were reviewed. Twenty patients (11 male) aged 43.2 +/- 16.1 years were studied. In nine, the endocarditis was subacute, and 80% had a history of valvular or congenital heart disease. The principal clinical complication was sepsis followed by neurological, nephrological and cardiac complications. The necropsy disclosed cardiac, nephrological and abdominal lesions in 100, 80 and 65% of patients respectively. In 65% of necropsies, neurological injuries were found (cerebral edema in 7 patients and hemorrhagic complications in 11). It is concluded that extra cardiac lesions are frequent in patients dying with a diagnosis of infective endocarditis.

[Analysis of data from a database of patients submitted to cardiac catheterization]. / Aportes de una base de datos de pacientes sometidos a sondeo cardiaco.

77 variables with data from clinical, non invasive and invasive findings in 591 adult patients submitted to cardiac catheterization and/or coronary arteriography from 1988 to 1991 were analyzed. 51% had coronary arteriography for suspected coronary artery disease: 15% had no or insignificant disease and 8% had main left disease. Among 92 patients with valvular heart disease, coronary angiography ruled out coronary disease in 80%. In this group, 3 vessel disease was found only in patients older than 62 years of age and main left disease was rare. The etiology of valve disease was rheumatic in 72%. Congenital heart disease was the indication for invasive study in 8% of patients, atrial septal defect being the most common entity.

[Infectious endocarditis: clinical and echocardiographic initial follow-up]. / Endocarditis infecciosa: seguimiento inicial clínico-ecocardiográfico.

We analyzed the clinical and echocardiographic features of 24 patients with infective endocarditis followed for a mean of 20.2 month (range 3-84) after discharge. Mean age was 38 years, male to female ratio was 2:1 and 87% of cases had a subacute clinical course; 17% of patients had late prosthetic endocarditis. Positive blood cultures were obtained in only 50% of patients. Vegetations were detected by echocardiography in 88%, 66% of them located at the aortic valve. Heart failure (62%) was the main complication, leading to valve replacement in 4 patients. Four patients died during follow up, 3 males due to heart failure and a female from systemic emboli. Twenty patients survive at the end of follow up (84%), 50% of them in FC I or II, 40% in FC III or IV (2 lost to follow up). Eleven patients had a late echocardiogram at a mean of 12 months after discharge: 6 of them showed persistence of vegetations (55%).