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妊娠期主动脉瓣亚急性感染性心内膜炎

Subacute Infective Endocarditis of Aortic Valve During Pregnancy.

作者信息

Wajih Ullah Muhammad, Lakhani Sunita, Sham Sunder, Ashraf Fariha, Siddiq Wardah, Siddiqui Tariq

机构信息

Cardiology, Mayo Clinic, Rochester, USA.

Internal Medicine, Liaquat University of Medical and Health Sciences Hospital Jamshoro Sindh Pakistan., Jamshoro, PAK.

出版信息

Cureus. 2018 Jun 5;10(6):e2748. doi: 10.7759/cureus.2748.

Abstract

Bacterial infective endocarditis is a rare but a life-threatening infection during pregnancy. Infective endocarditis during pregnancy is often associated with a congenital heart condition or an earlier history of rheumatic heart disease. In pregnant women with infective endocarditis, the maternal and fetal mortality rate can reach as high as 33% and 29%, respectively. In most cases, infective endocarditis runs a subacute course and involves the mitral valve, nonetheless, rarely it can involve the aortic valve as well. We are documenting a rare case of subacute infective endocarditis in a 26-year-old pregnant female with severe aortic stenosis with associated multiple systemic emboli. The patient was managed by urgent cesarean section at 35 weeks of gestation followed by aortic valve replacement; there was no maternal or fetal mortality. This case report highlights the importance of early diagnosis, and timely management of infective endocarditis in pregnant women to prevent maternal and fetal death.

摘要

细菌性感染性心内膜炎是妊娠期一种罕见但危及生命的感染。妊娠期感染性心内膜炎常与先天性心脏病或既往风湿性心脏病史有关。患有感染性心内膜炎的孕妇,母婴死亡率分别可高达33%和29%。在大多数情况下,感染性心内膜炎呈亚急性病程,累及二尖瓣,不过,极少数情况下也可累及主动脉瓣。我们记录了一例罕见的亚急性感染性心内膜炎病例,患者为一名26岁的重度主动脉瓣狭窄孕妇,伴有多发全身栓塞。该患者在妊娠35周时紧急剖宫产,随后进行主动脉瓣置换;母婴均未死亡。本病例报告强调了早期诊断以及及时处理孕妇感染性心内膜炎以预防母婴死亡的重要性。

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