Jorge S do C, Arêas C A, Shibata M, Assef J E, Arnoni A S, Zamorano M M, da Silva L M, Souza L C, Piegas L S, Magalhães H M
Instituto Dante Pazzanese de Cardiologia, São Paulo.
Arq Bras Cardiol. 1994 Feb;62(2):107-11.
Two patients with chronic valvular heart disease and myocardial infarction were assisted at our hospital. Both of them were febrile and only one had petechiae associated with signs of valvular involvement led to suspicion of infective endocarditis. Although blood cultures were negative, echocardiographic, surgical and anatomopathologic findings were compatible with infective endocarditis. They required cardiac surgery during the acute phase of the infection because they presented progressive hemodynamic deterioration and no satisfactory response to antimicrobial regimen too. One patient died at late follow-up (two weeks after the hospital discharge) and the other survived, but with signs of cardiac failure (class II of NYHA) one year after the procedure.
我院收治了两名患有慢性瓣膜性心脏病和心肌梗死的患者。两人均发热，只有一人有瘀点并伴有瓣膜受累体征，这引发了对感染性心内膜炎的怀疑。尽管血培养结果为阴性，但超声心动图、手术及解剖病理学检查结果均符合感染性心内膜炎。由于他们出现了进行性血流动力学恶化，且对抗菌治疗方案也无满意反应，因此在感染急性期需要进行心脏手术。一名患者在随访后期（出院两周后）死亡，另一名患者存活，但术后一年出现心力衰竭体征（纽约心脏病协会II级）。
