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功能性二尖瓣狭窄导致反复性急性肺水肿:草绿色链球菌心内膜炎非典型并发症的病例报告

Functional Mitral Stenosis Resulting in Recurrent Flash Pulmonary Edema: A Case Report of an Atypical Complication of Streptococcus viridans Endocarditis.

作者信息

Patel Akash, Patel Jaimin

机构信息

Department of Medicine, Graduate Medical Education, Methodist Dallas Medical Center, Dallas, USA.

出版信息

Cureus. 2023 May 7;15(5):e38670. doi: 10.7759/cureus.38670. eCollection 2023 May.

Abstract

Infective endocarditis (IE) can present with a wide variety of clinical signs and symptoms, making it difficult to diagnose. Recognizing risk factors such as congenital heart disease, intravenous drug use, and prosthetic heart valves can encourage early testing with blood cultures and echocardiography, leading to prompt diagnosis and treatment with antibiotics. Despite early detection and treatment, IE can still result in permanent damage of the affected heart valves, most commonly resulting in valvular regurgitation and signs and symptoms of heart failure. Clinicians must maintain a high index of suspicion as prompt diagnosis and treatment are essential to prevent morbidity and mortality. Valvular stenosis as a result of IE, unlike valvular regurgitation, is extremely rare and has only been described a handful of times in literature. We present a unique case of IE resulting in functional mitral stenosis and recurrent flash pulmonary edema in an elderly female who had recently undergone a dental cleaning procedure.

摘要

感染性心内膜炎(IE)可表现出多种多样的临床体征和症状,这使得其诊断困难。识别诸如先天性心脏病、静脉吸毒和人工心脏瓣膜等风险因素,可促使早期进行血培养和超声心动图检查,从而实现抗生素的及时诊断和治疗。尽管进行了早期检测和治疗,但IE仍可能导致受影响心脏瓣膜的永久性损害,最常见的是导致瓣膜反流和心力衰竭的体征及症状。临床医生必须保持高度的怀疑指数,因为及时诊断和治疗对于预防发病和死亡至关重要。与瓣膜反流不同,IE导致的瓣膜狭窄极为罕见,在文献中仅被描述过几次。我们报告了一例独特的IE病例,该病例导致一名近期接受过洗牙治疗的老年女性出现功能性二尖瓣狭窄和反复性急性肺水肿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d8/10243281/6d770e994633/cureus-0015-00000038670-i01.jpg

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