Schalla Gregory, Grant Michael
In the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins Medical Institutions in Baltimore, Md., Gregory Schalla is a PA resident and Michael Grant is an assistant professor. The authors have disclosed no potential conflicts of interest, financial or otherwise.
JAAPA. 2020 May;33(5):1-4. doi: 10.1097/01.JAA.0000660140.73476.f3.
A patient who presented after falling out of bed had signs of right-sided stroke, which, after imaging, was suspicious for embolism with cardiac origin. Further investigation revealed a large aortic valve vegetation with mild aortic insufficiency, and the patient eventually developed heart failure requiring surgical intervention. Infective endocarditis is slowly becoming more prevalent, and clinicians should have a high index of suspicion when patients present with common complications of this disease, such as valvular dysfunction, heart failure, or stroke. Early diagnosis has been shown to reduce time to appropriate antibiotic treatment and definitive care, which can lead to better outcomes.
一名因从床上摔下后就诊的患者出现右侧中风迹象，经影像学检查后，怀疑是心源性栓塞。进一步检查发现主动脉瓣有一大块赘生物，伴有轻度主动脉瓣关闭不全，该患者最终发展为心力衰竭，需要进行手术干预。感染性心内膜炎正逐渐变得越来越普遍，当患者出现该病的常见并发症，如瓣膜功能障碍、心力衰竭或中风时，临床医生应高度怀疑。早期诊断已被证明可缩短开始适当抗生素治疗和确定性治疗的时间，从而带来更好的治疗效果。
