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[Septic myocardial aneurysm in mitral valve endocarditis. Clinical and pathological-anatomical findings].
- Source :
-
Deutsche medizinische Wochenschrift (1946) [Dtsch Med Wochenschr] 1997 Feb 07; Vol. 122 (6), pp. 156-60. - Publication Year :
- 1997
-
Abstract
- History and Clinical Findings: A 68-year-old woman was hospitalized because of fever and tiredness for 3 months. Her general condition was clearly impaired. She had a mild fever of 38.5 degrees C and on auscultation a 3/6 systolic murmur, maximal parasternally in the 3rd intercostal space, transmitted to the apex. There were distant râles over both lungs, the neck veins were distended and there was ankle oedema.<br />Investigations: C-reactive protein was raised to 17.3 mg/dl (normal up to 0.9 mg/dl), WBC count 19,300/microliter. beta-haemolysing streptococcus (S. agalactiae) was grown in the blood culture. The ECG showed sinus tachycardia (rate of 98/min) and transthoracic echocardiography demonstrated a small pericardial, enlarged ventricles, marked mitral regurgitation and a large vegetation on the posterior mitral leaflet, as well as a 3 x 4 cm mass in the posterior wall of the ventricle, originating from the posterior mitral valve ring and communicating with the vegetation on the mitral valve. The posterior mitral leaflet was perforated.<br />Treatment and Course: As endocarditis of the mitral valve with a complicated course was suspected-abscess of the posterior mitral valve ring and septic myocardial aneurysm with associated pericarditis and haemodynamically insignificant effusion-she was transferred to the intensive care unit where she died suddenly of circulatory arrest only 30 min after transfer. Autopsy confirmed the echocardiographic findings.<br />Conclusion: Paravalvular abscess in the course of mitral valve endocarditis is rare, but should be looked for at transthoracic echocardiography so that any necessary surgical intervention can be undertaken early.
- Subjects :
- Aged
Autopsy
Electrocardiography
Endocarditis, Bacterial pathology
Female
Heart Aneurysm pathology
Humans
Mitral Valve Insufficiency pathology
Myocardium pathology
Sepsis pathology
Endocarditis, Bacterial diagnosis
Heart Aneurysm diagnosis
Mitral Valve Insufficiency diagnosis
Sepsis diagnosis
Subjects
Details
- Language :
- German
- ISSN :
- 0012-0472
- Volume :
- 122
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Deutsche medizinische Wochenschrift (1946)
- Publication Type :
- Academic Journal
- Accession number :
- 9081801
- Full Text :
- https://doi.org/10.1055/s-2008-1047590