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[获得性免疫缺陷综合征、肥厚型心肌病与多瓣膜感染性心内膜炎。关于一例临床病例]

[The acquired immunodeficiency syndrome, hypertrophic myocardiopathy and multivalvular infectious endocarditis. Apropos a clinical case].

作者信息

Jaques A K, Arroja I, Araújo C, Azevedo J, Borges A, Santos I, Cabral A, Campos M J, Mansinho K, Borges F

机构信息

Laboratório de Ecocardiografia, Hospital Egas Moniz, Lisboa.

出版信息

Rev Port Cardiol. 1995 Jan;14(1):53-8.

PMID:7695955
Abstract

We present a clinical case of a 33 years old young male, gypsy, intravenous drug abuser with heroine and cocaine and AIDS diagnosis. The clinical anamnesis was mainly fever and systolic heart murmur in a clinical scenario of AIDS. The two-dimensional echocardiographic study was clearly diagnostic of an hypertrophic obstructive cardiomyopathy of the left ventricle. This study showed also the presence of multiple vegetations of the mitral, aortic and pulmonic valves in a clinical setting of an acute Streptococcus Viridans infective endocarditis. In this case report we discuss the incidence of this type of multiple cardiac lesions and particularly the presence of this specific pathogenic agent in this high risk group of patients with intravenous drug abuse and systemic immunosuppression. We pointed out the rarity of these findings of left side valvular vegetations associated with this type of cardiomyopathy and the different factors related to infective endocarditis.

摘要

我们报告一例临床病例,患者为一名33岁的年轻男性吉普赛人,静脉注射海洛因和可卡因成瘾且患有艾滋病。临床问诊主要发现其在艾滋病病情下出现发热和收缩期心脏杂音。二维超声心动图研究明确诊断为左心室肥厚性梗阻性心肌病。该研究还显示,在急性草绿色链球菌感染性心内膜炎的临床背景下,二尖瓣、主动脉瓣和肺动脉瓣存在多处赘生物。在本病例报告中,我们讨论了这类多发性心脏病变的发生率,特别是在这种静脉药物滥用和全身免疫抑制的高危患者群体中这种特定病原体的存在情况。我们指出,与这类心肌病相关的左侧瓣膜赘生物的这些发现很罕见,以及与感染性心内膜炎相关的不同因素。

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