digoxin and Endocarditis--Bacterial

Topics: Adolescent; Captopril; Cardiomyopathies; Child; Digoxin; Dobutamine; Dopamine; Echocardiography; Electrocardiography; Endocarditis, Bacterial; Furosemide; Heart; Heart Defects, Congenital; Heart Diseases; Heart Failure; Humans; Hydralazine; Isoproterenol; Nitroprusside; Physical Examination; Radionuclide Imaging; Rheumatic Heart Disease

The authors report on a 47-years old woman with bacterial endocarditis involving both the mitral and aortic valves. At first echocardiographic examination, the mitral vegetation was small, while the aortic one was large highly mobile. Despite adequate antibiotic therapy, the aortic vegetation had become bigger and the valve regurgitation, initially mild to moderate, resulted severe and was associated with left heart failure. While awaiting surgery, the patient sustained an acute non Q wave myocardial infarction with ST segment elevation in inferior and anterolateral leads, complicated by ventricular arrhythmias. Thirty-six hours later, the patient received mitral and aortic valve replacement: at surgical view, the aortic vegetations was found to be very close to the right coronary orifice. After a period of further antibiotic therapy, the woman discharged and at a six months follow-up, she was fairly well. The authors review the mechanisms of acute coronary insufficiency in infective endocarditis and suggest an embolic pathogenesis in the case reported. Taking into account the possible life threatening embolic complications, it seems reasonable not to delay surgery when antibiotic therapy fails to reduce the size and mobility of valve vegetations.

Topics: Aortic Valve; Aortic Valve Insufficiency; Cardiotonic Agents; Digoxin; Diuretics; Echocardiography, Doppler, Color; Echocardiography, Transesophageal; Electrocardiography; Embolism; Endocarditis, Bacterial; Female; Follow-Up Studies; Furosemide; Heart Valve Prosthesis; Humans; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; Myocardial Infarction; Penicillin G; Penicillins; Streptococcal Infections; Time Factors

Topics: Animals; Anti-Arrhythmia Agents; Anti-Bacterial Agents; Arrhythmias, Cardiac; Cardiac Output; Cardiotonic Agents; Cardiovascular Diseases; Digoxin; Drug Utilization Review; Endocarditis, Bacterial; Heart; Heart Failure; Horse Diseases; Horses

Topics: Arrhythmia, Sinus; Arrhythmias, Cardiac; Coronary Disease; Digoxin; Diuretics; Electroconvulsive Therapy; Endocarditis, Bacterial; Heart Aneurysm; Heart Failure; Heart Valve Diseases; Heart Ventricles; Humans; Lidocaine; Myocardial Infarction; Pacemaker, Artificial; Pericarditis, Constrictive; Potassium Deficiency; Rupture; Spironolactone; Tachycardia; Ventricular Fibrillation; Wolff-Parkinson-White Syndrome

Topics: Adult; Age Factors; Aminoglycosides; Anti-Bacterial Agents; Carbenicillin; Diabetes Complications; Digoxin; Drug Hypersensitivity; Drug Therapy, Combination; Endocarditis, Bacterial; Gentamicins; Heart Failure; Humans; Kanamycin; Male; Neurologic Manifestations; Penicillin Resistance; Penicillins; Pseudomonas aeruginosa; Pseudomonas Infections; Sex Factors; Substance-Related Disorders

Topics: Adult; Digoxin; Dyspnea; Electrocardiography; Endocarditis, Bacterial; Endocarditis, Subacute Bacterial; Female; Humans; Hypotension; Lincomycin; Male; Nausea; Sepsis; Staphylococcal Infections; Vomiting

Topics: Angiography; Aortic Valve; Cardiac Catheterization; Digoxin; Diuretics; Electrocardiography; Endocarditis, Bacterial; Fluoroscopy; Heart Failure; Humans; Lincomycin; Male; Middle Aged; Radiography, Thoracic

Topics: Adult; Africa, Central; Black or African American; Black People; Diagnosis, Differential; Digoxin; Endocarditis, Bacterial; Endomyocardial Fibrosis; Heart Failure; Humans; Mitral Valve Stenosis; Organomercury Compounds; Pulmonary Edema; Tropical Medicine

Topics: Brain Diseases; Chloramphenicol; Chlorothiazide; Digoxin; Diuretics; Drug Therapy; Endocarditis; Endocarditis, Bacterial; Erysipelothrix; Heart Failure; Heart Valve Diseases; Humans; Methicillin; Organomercury Compounds; Penicillin V; Penicillins; Probenecid; Sepsis

Topics: Aged; Aortic Valve; Aortic Valve Stenosis; Arrhythmias, Cardiac; Cardiac Catheterization; Cardiac Surgical Procedures; Digoxin; Endocarditis; Endocarditis, Bacterial; Heart Failure; Heart Valve Diseases; Heart Valve Prosthesis; Heart, Artificial; Humans; Isoproterenol; Methicillin; Middle Aged; Postoperative Complications; Psychoses, Substance-Induced; Psychotic Disorders; Thoracic Surgery; Warfarin