Tarasoutchi F, Grinberg M, Barreto Filho J A, Vasconcelos J T, Cardoso L F, Lunardi W, Mansur A, Pomerantzeff P, da Luz P L, Bellotti G
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.
Arq Bras Cardiol. 1994 Sep;63(3):203-5.
We studied five patients with acquired ventricular septal defect during the course of an infective endocarditis. All patients were male and had a previous aortic valve disease associated with an aortic ring abscess. Clinical examination was useful for the diagnosis of 4 cases, emphasizing the following findings: systolic murmur and/or left paraesternal thrill and right-heart failure. Incidence of congestive heart failure was 60%, while 40% of all patients died during the in-hospital course. No specific etiologic agent was detected. Therefore, acquired ventricular septal defect should be suspected in patients with infective endocarditis of the aortic valve that evolve with a systolic murmur and/or paraesternal thrill and right-heart failure. Immediate surgical treatment is mandatory in these cases.
我们研究了5例在感染性心内膜炎病程中出现获得性室间隔缺损的患者。所有患者均为男性，既往有与主动脉环脓肿相关的主动脉瓣疾病。临床检查对4例患者的诊断有帮助，重点发现如下：收缩期杂音和/或胸骨旁左缘震颤以及右心衰竭。充血性心力衰竭的发生率为60%，而所有患者中有40%在住院期间死亡。未检测到特定病原体。因此，对于患有主动脉瓣感染性心内膜炎且伴有收缩期杂音和/或胸骨旁震颤及右心衰竭的患者，应怀疑有获得性室间隔缺损。在这些情况下，立即进行手术治疗是必要的。
