RESUMO
Since the introduction of penicillin in 1942, there have been only 11 culture-proven cases of gonococcal endocarditis in the English literature. Most patients are under 30 years of age and have no history of heart disease. The aortic valve is often involved and aortic regurgitation is common. The bacteriologic diagnosis can be difficult and may require more than six blood cultures and a long incubation period. Circulating immune complexes appear to be the cause of many of the extracardiac manifestations. The three new cases reported herein and review of the literature emphasize the distinctive features of gonococcal endocarditis.
Assuntos
Endocardite Bacteriana/tratamento farmacológico , Gonorreia/tratamento farmacológico , Penicilina G/uso terapêutico , Adulto , Insuficiência da Valva Aórtica/etiologia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico , Gonorreia/complicações , Gonorreia/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Echocardiography was used to evaluate left ventricular function in 43 consecutive patients with suspected cor pulmonale who clinically had no other heart disease or hypertension. Adequate echocardiographic evidence was obtained by either standard left parasternal position or subxiphoid position in 40 patients (93%). Echocardiographic evidence of either dilatation of the left ventricular cavity or thickening of the right ventricular free wall was present in 37 patients (93%). Small left ventricular end-diastolic cavities suggested that many of these patients had functional left ventricle volume depletion. Echocardiographic evidence of left ventricular dysfunction was present in only three patients (8%).