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感染性心内膜炎:特发性肥厚性主动脉瓣下狭窄的一种并发症(作者译)

[Infective endocarditis: a complication of idiopathic hypertrophic subaortic stenosis (author's transl)].

作者信息

Mazzoli M, Tafani O, Vergassola R

出版信息

G Ital Cardiol. 1980;10(9):1228-33.

PMID:7193153
Abstract

The idiopathic hypertrophic subaortic stenosis (IHSS) is thought to be infrequently complicated by infective endocarditis. Because IHSS is a disorder of the myocardium and not endocardium is not generally considered to have increased risk of infective endocarditis. Some Authors found, however, that approximately 5% of patients with IHSS develop bacterial endocarditis, because hemodynamically IHSS is like to valvular diseases. Therefore the incidence of endocarditis in IHSS is the same of valvular diseases. The vegetations can be found on anterior mitral valve leaflet, aortic cusps and subaortic endocardium. Some patients have dental surgery prior to the onset of endocarditis and others are infected with oral streptococci. For these reasons prophylactic antibiotics should be administered to patients with IHSS undergoing dental manipulation and in other settings where the risk of developing bacteremia is high. We describe one case of IHSS complicated with streptococcus viridans endocarditis. Vegetations, determined with echocardiography, were present on anterior mitral valve leaflet, aortic right coronary cusp and interventricular septum. In a review of literature we are been able to find twenty-seven cases of IHSS complicated with endocarditis.

摘要

特发性肥厚性主动脉瓣下狭窄(IHSS)被认为很少并发感染性心内膜炎。由于IHSS是一种心肌疾病而非心内膜疾病,通常不认为其感染性心内膜炎的风险会增加。然而,一些作者发现,约5%的IHSS患者会发生细菌性心内膜炎,因为从血流动力学角度来看,IHSS类似于瓣膜疾病。因此,IHSS的心内膜炎发病率与瓣膜疾病相同。赘生物可出现在二尖瓣前叶、主动脉瓣叶和主动脉瓣下内膜。一些患者在心内膜炎发作前接受过牙科手术,另一些患者感染了口腔链球菌。出于这些原因,对于接受牙科操作以及处于发生菌血症风险较高的其他情况下的IHSS患者,应给予预防性抗生素治疗。我们描述了一例IHSS并发草绿色链球菌心内膜炎的病例。经超声心动图检查确定,二尖瓣前叶、主动脉右冠状动脉瓣叶和室间隔上存在赘生物。在文献回顾中,我们找到了27例IHSS并发心内膜炎的病例。

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