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感染性心内膜炎合并心肌脓肿,并发经皮腔内冠状动脉成形术。

Infective endocarditis with myocardial abscesses complicating percutaneous transluminal coronary angioplasty.

作者信息

Shibata Toshihiko, Hirai Hidekazu, Fujii Hiromichi, Aoyama Takanobu, Seuhiro Shigefumi

机构信息

Department of Cardiovascular Surgery, Osaka City University Medical School, Osaka, Abeno, Japan.

出版信息

J Heart Valve Dis. 2002 Sep;11(5):665-7.

Abstract

A 73-year-old man who had undergone percutaneous transluminal coronary angioplasty developed infectious endocarditis caused by Staphylococcus aureus. Echocardiography revealed vegetations of the aortic valve and severe aortic regurgitation. Endotracheal intubation was required for progressive heart failure. Serum creatinine kinase was elevated (411 IU/l: normal 30 to 140 IU/l). Electrocardiography showed no ischemic changes. Aortic replacement was performed to treat progressive heart failure, but the patient could not be weaned off cardiopulmonary bypass and subsequently died. A post-mortem examination revealed multiple myocardial microabscesses and myocardial infarction due to embolic vegetation. The possibility of multiple abscess formation when severe ventricle dysfunction occurs in infectious endocarditis is emphasized.

摘要

一名73岁男性,曾接受经皮腔内冠状动脉成形术,发生了由金黄色葡萄球菌引起的感染性心内膜炎。超声心动图显示主动脉瓣有赘生物及严重主动脉瓣反流。因进行性心力衰竭需要气管插管。血清肌酐激酶升高(411 IU/L:正常范围30至140 IU/L)。心电图未显示缺血性改变。为治疗进行性心力衰竭进行了主动脉置换,但患者无法脱离体外循环,随后死亡。尸检显示有多个心肌微脓肿以及因赘生物栓塞导致的心肌梗死。强调了感染性心内膜炎出现严重心室功能障碍时形成多个脓肿的可能性。

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