Winkelmann M, Curtius J M, Hoffmann V, Frenzel H
Z Kardiol. 1986 Aug;75(8):505-8.
Clinical and pathological findings in a 37-year-old female patient with HOCM and infective endocarditis of the aortal and mitral valves were reported. The patient died of septic shock. Infective endocarditis with acute insufficiency of the aortal and/or mitral valves is a severe complication in patients with HOCM, because the left ventricle with a disturbed compliance is unable to compensate the acute volume overload. The standard use of nitrates for congestive lung failure and catecholamines for septic shock is problematic. As with other valvular heart diseases, preventive treatment for infective endocarditis is also recommended for patients with HOCM. In the case of acute endocarditis combined with HOCM early surgical intervention must be discussed.
报告了一名37岁患有肥厚型梗阻性心肌病(HOCM)及主动脉瓣和二尖瓣感染性心内膜炎的女性患者的临床和病理检查结果。该患者死于感染性休克。伴有主动脉瓣和/或二尖瓣急性功能不全的感染性心内膜炎是HOCM患者的一种严重并发症,因为顺应性受损的左心室无法代偿急性容量负荷过重。对于充血性肺衰竭使用硝酸盐以及对于感染性休克使用儿茶酚胺的标准治疗方法存在问题。与其他瓣膜性心脏病一样,也建议对HOCM患者进行感染性心内膜炎的预防性治疗。对于合并HOCM的急性心内膜炎病例,必须讨论早期手术干预。