Cardiology Commons^™

A “Fishy” Situation, Rare Pathogen And Presentation In Prosthetic Valve Infective Endocarditis, Nichole Schtupak, Patrick Kennedy, Darko Pucar, Linda Godinez, Jodi-Ann Chin, Kristen Selema, Dipan Uppa, Antonio Lewis, Marcelo Helguera

DMSc Student Publications

Lactococcus garviae (L. garviae) is a gram-positive coccus belonging to the Streptococcaceae family. While primarily a pathogen in fish farms causing hemorrhagic sepsis, it can act as a rare opportunistic pathogen in humans. A 2021 case report by Bravo et al. documented less than 30 cases of infective endocarditis caused by L. garviae worldwide at that time. This case report describes the 27th documented case globally and 7th documented case in the USA of L. garviae causing infective endocarditis of a prosthetic valve.
L. garviae is found in unpasteurized dairy products, raw fish, and meat (pork, beef, and …

Swiss Cheese Heart: A Tale Of Multiple Valve Perforations, Hussam Al Hennawi, Shayan I. Khan, Aamna Khan, Usama Sadiq, Sung-Hae Cho

Abington Jefferson Health Papers

Gerbode defect, an anomalous connection between the left ventricle and right atrium, is often congenital but can be acquired or iatrogenically formed. We present an exceedingly rare case of this defect associated with multiple valve perforation in an otherwise healthy patient with bicuspid aortic valve and endocarditis.

Infective Endocarditis Secondary To Needle Embolization To The Heart, Tony Elias, David Barsoum, Robert Malak, Veyola Rezkalla, Maziyar Daneshvar, Howard Weinberg, Rafail Beshai

Rowan-Virtua Research Day

Needle embolisms in the heart are very rare, even though the number of intravenous drug users (IVDUs) has increased over the past 10 years.Due to varied symptomology-chest pain, dyspnoea, fever, or asymptomatic, this remains a complex and likely underdiagnosed condition. We describe a 31-year-old female with past medical history of IV drug use who presented to the emergency room with heart palpitations and described it as her “heart feels funny” and shortness of breath. She acknowledged intravenous (IV) heroin use and stated that the last time to use IV drugs was 2 days before coming to the hospital.

To our …

The Angiovac® Device Limits Lethal Complications Of Sepsis And Severe Infective Endocarditis With A Large Tricuspid Valve Vegetation: A Case Report, Dua Xiao, Raeann Dalton, Adam Fineman, Michael Benz, Antonios Tsompanidis

Rowan-Virtua Research Day

Introduction: Infectious endocarditis of the tricuspid valve is a common complication of intravenous drug use. Endocarditis caused by viridans streptococci can lead to heart valve vegetations which may be life threatening due to the potential for embolism and obstruction. Management of large valvular vegetations is often difficult due to the risks involved with open heart surgery, especially in patients with comorbid conditions. The AngioVac® device has been shown in rare cases to be effective at debulking vegetations without the need for invasive surgery.

Case Presentation: We present a patient with a history of intravenous heroin use disorder, hepatitis C, spinal …

Cardiac Surgery For Treatment Of Covid-19-Associated Infectious Endocarditis, Ali Taghizadeh-Waghefi, Asen Petrov, Manuel Wilbring, Konstantin Alexiou, Utz Kappert, Klaus Matschke, Sems-Malte Tugtekin

The Texas Heart Institute Journal

BACKGROUND: Significant uncertainty exists about the optimal timing of surgery for infectious endocarditis (IE) surgery in patients with active SARS-CoV-2 infection. This case series and a systematic review of the literature were carried out to evaluate the timing of surgery and postsurgical outcomes for patients with COVID-19-associated IE.

METHODS: The PubMed database was searched for reports published from June 20, 2020, to June 24, 2021, that contained the terms infective endocarditis and COVID-19. A case series of 8 patients from the authors' facility was also added.

RESULTS: A total of 12 cases were included, including 4 case reports that met …

The Cloak Of Invisibility: Subclinical Infective Endocarditis Resulting In Chordae Tendineae Rupture In Mitral Valve Prolapse, Jason Naftulin, Trinava Roy, Anjeli Patel, Steven Silver

Rowan-Virtua Research Day

While Chordae tendineae rupture(CTR) is often caused due to mitral valve prolapse, rheumatic heart disease or infective endocarditis, CTR secondary to a combination of the factors is not often seen. We present a unique case of CTR due to subclinical infective endocarditis(IE) with underlying mitral valve prolapse(MVP).

A Case Of Isolated Pulmonic Valve Candida Endocarditis, Michael Hoban, Scott Searing

Posters

• Endocarditis is a rare and potentially lethal disease affecting 3 to 10 per 100,000 in the United States, with 40,000 to 50,000 new cases per year. • The major risk factors for development of endocarditis are prosthetic valves, hemodialysis, venous catheters, immunosuppression, and IV drug use. • Fungal endocarditis accounts for 1-10% of all endocarditis cases and has been associated with increased mortality. • Isolated pulmonic valve endocarditis is extremely rare accounting for < 2% of patients with infective endocarditis. • Transthoracic echocardiography is the initial imaging modality of choice and has sensitivity of 50-90%. TEE is 90-100% sensitive.

Infective Endocarditis: An Old Problem With A Changing Face, Kin-Lam Tsui

Journal of the Hong Kong College of Cardiology

No abstract provided.

A Retrospective Study On The Predictors Of Outcome In Patients With Infective Endocarditis, Yuen-Fung Yiu

Journal of the Hong Kong College of Cardiology

Background Infective endocarditis (IE) is associated with significant mortality and morbidity. This study aims to update the epidemiology of IE and to identify predictors of adverse outcome in the Chinese population in Hong Kong.

Methods This was a single-centre retrospective study of patients diagnosed with IE in Princess Margaret Hospital in Hong Kong during 2002-2016. Primary outcome was defined as in-hospital mortality. Secondary outcomes included 1-year mortality, valvular surgical intervention, heart failure, stroke and systemic embolization.

Results In total, 196 patients with definite or possible IE were included in the study. The incidence of IE was 2.26 per 100,000 person-years …

Native Valve Endocarditis Complicated By Abscess Formation Caused By Rothia Mucilaginosa, S Haddad, Y Saade, B Ramlawi, B Kreidieh, B Gilbert, S Rao

Division of Infectious Diseases and Environmental Medicine Faculty Papers

Rothia mucilaginosa is increasingly recognized as an emerging pathogen associated with endocarditis. It has mostly been reported a causative agent for prosthetic valve endocarditis. The previously reported cases of native valve endocarditis caused by this organism only required medical treatment with no surgical intervention. We report a case of R. mucilaginosa native valve endocarditis complicated by abscess formation requiring surgical intervention and review the literature of native valve endocarditis caused by this organism.

Surgical Treatment Of Valvular Heart Disease In Nigeria: A 6-Year Experience, Ikechukwu A Nwafor, John C Eze, Maureen N Nwafor

The Texas Heart Institute Journal

Surgical treatment of valvular heart disease in Nigeria, the most populous country in sub-Saharan Africa, is adversely affected by socioeconomic factors such as poverty and ignorance. To evaluate our experience in this context, we identified all patients who underwent surgery for acquired or congenital valvular heart disease at our Nigerian center from February 2013 through January 2019. We collected data from their medical records, including patient age and sex, pathophysiologic causes and types of valvular disease, surgical treatment, and outcomes. Ninety-three patients (43 males [46.2%]; mean age, 38.9 ± 10.0 yr [range, 11–80 yr]) underwent surgical treatment of a total …

Brucella Prosthetic Valve Endocarditis: A Systematic Review, Karima Taamallah, Fatma Hammami, Hedi Gharsallah, Makram Koubaa, Mounir Ben Jemaa, Wafa Fehri

Journal of the Saudi Heart Association

Objective: Brucella prosthetic valve endocarditis is a rare but a life-threatening complication of brucellosis. It remains a diagnostic challenge. Optimal treatment of Brucella prosthetic valve endocarditis is debated. Available data is limited to case reports or small case series. The purpose of this study was to systematically review all published cases of Brucella prosthetic valve endocarditis in the literature. Method: A systematic review of PubMed database, Google, Google Scholar, and Scopus (From January 1974 to the present) for studies providing epidemiological, clinical and microbiological data as well as data on treatment and outcomes of Brucella prosthetic valve endocarditis was performed. …

From Leads To Leadless: A Convoluted Journey, Vipin Dulam, Joshua M. Cooper, Chethan Gangireddy, Mohammed A. Kashem, Yoshiya Toyoda, Suresh Keshavamurthy

Surgery Faculty Publications

No abstract provided.

Bedside Point Of Care Ultrasound Diagnosing Bilateral Valve Involvement In Infective Endocarditis, Corey Cole, Alfredo Tirado, Jonathan Schwadron

West Florida Division GME Research Day 2020

Endocarditis is a well known complication of intravenous drug abuse which classically affects the tricuspid valve. It is usually diagnosed by formal echocardiogram and positive blood cultures. Vegetations involving both the mitral and tricuspid valves are rare, occurring in less than 5% of all cases of infective endocarditis. 1 Here we report a case of a patient with vegetations on both valves which was discovered by point of care ultrasound.

Use Of Epic Emr For Early Identification And Management Of Patients At Risk Of Cardiac Implantable Electronic Device (Cied) Infection, Priya Rajagopalan, Md, Yair Lev, Md, Arnold J. Greenspon, Md

Health Equity and Quality Improvement (HEQI) Summit

Objectives

• Aim of our project was early identification of 100% of patients with a CIED IMPLANT presenting with bacteremia
• Process involves use of EPIC EMR to automatically identify patients with positive blood cultures
• Traditionally, cardiologists are alerted by the care team using the CONSULT system for management of these patients
• EPIC EMR as an adjunct to the CONSULT system

A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., George M. Yousef, Paul I. Okhumale, Haytham Aljoudi, Silvestre Cansino

Silvestre P. Cansino

A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari's network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case.

A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., George M. Yousef, Paul I. Okhumale, Haytham Aljoudi, Silvestre Cansino

George M. Yousef

A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari's network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case.

A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., George M. Yousef, Paul I. Okhumale, Haytham Aljoudi, Silvestre Cansino

Marshall Journal of Medicine

A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari's network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case.

"Eyeing" The Cause Of Heart Failure: Visible Telltale Clues, Herbert L Fred, Manoj Thangam

The Texas Heart Institute Journal

No abstract provided.

Endocarditis And Incomplete Endothelialization 12 Years After Amplatzer Septal Occluder Deployment, Allan K Nguyen, Brian A Palafox, Joanne P Starr, Richard N Gates, Farbouch Berdjis

The Texas Heart Institute Journal

A 4-year-old boy had a 15-mm atrial septal defect repaired percutaneously with use of an Amplatzer Septal Occluder. At age 16 years, he presented with a week's history of fever, chills, dyspnea, fatigue, and malaise. Cultures grew methicillin-sensitive Staphylococcus aureus. A transesophageal echocardiogram showed a 1.25 × 1.5-cm pedunculated mass on the left aspect of the atrial septum just superior to the mitral valve, and a smaller vegetation on the right inferior medial aspect of the septum. At surgery, visual examination of both sides of the septum revealed granulation tissue, the pedunculated mass, the small vegetation, and exposed metal …

Corrigendum For “Acute Aortic Valve Rupture From Infective Endocarditis”, Julia Ansari, Gurkaran Singh Garcha, Henry Huang, Faisal G. Bakaeen, Salim S. Virani, Hani Jneid

Office of the Provost

No abstract provided.

Infective Endocarditis In The U.S., 1998–2009: A Nationwide Study, David H. Bor, Steffie Woolhandler, Rachel Nardin, David Brusch, David U. Himmelstein

Publications and Research

Background
Previous studies based on local case series estimated the annual incidence of endocarditis in the U.S. at about 4 per 100,000 population. Small-scale studies elsewhere have reported similar incidence rates. However, no nationally-representative population-based studies have verified these estimates.

Methods and Findings
Using the 1998–2009 Nationwide Inpatient Sample, which provides diagnoses from about 8 million U.S. hospitalizations annually, we examined endocarditis hospitalizations, bacteriology, co-morbidities, outcomes and costs. Hospital admissions for endocarditis rose from 25,511 in 1998 to 38, 976 in 2009 (12.7 per 100,000 population in 2009). The age-adjusted endocarditis admission rate increased 2.4% annually. The proportion of patients …

Acute Aortic Valve Rupture From Infective Endocarditis After Transrectal Prostate Biopsy: A Call To Revise The Aha Guidelines For Prevention Of Infective Endocarditis, Julia Ansari, Gurkaran Singh Garcha, Henry Huang, Faisal G. Bakaeen, Salim S. Virani, Hani Jneid

Office of the Provost

We describe the case of a 63-year-old man with a known murmur who presented with a 4-month history of intermittent fever and a progressive reduction in energy level after a transrectal prostate biopsy (TRPB). He subsequently presented with acute heart failure secondary to aortic valve cusp rupture caused by endocarditis and underwent urgent aortic valve surgery. The 2008 American College of Cardiology/American Heart Association Guideline update on infective endocarditis has narrowed the use of antibiotic prophylaxis before most accepted dental procedures and continues to recommend against prophylaxis before genitourinary or gastrointestinal procedures. In contrast, the American Urological Association recommends the …

16-Year Trends In The Infection Burden For Pacemakers And Implantable Cardioverter-Defibrillators In The United States 1993 To 2008., Arnold J Greenspon, Jasmine D Patel, Edmund Lau, Jorge A Ochoa, Daniel R Frisch, Reginald T Ho, Behzad B Pavri, Steven M Kurtz

Department of Medicine Faculty Papers

OBJECTIVES: We analyzed the infection burden associated with the implantation of cardiac implantable electrophysiological devices (CIEDs) in the United States for the years 1993 to 2008.

BACKGROUND: Recent data suggest that the rate of infection following CIED implantation may be increasing.

METHODS: The Nationwide Inpatient Sample (NIS) discharge records were queried between 1993 and 2008 using the 9th Revision of the International Classification of Diseases (ICD-9-CM). CIED infection was defined as either: 1) ICD-9 code for device-related infection (996.61) and any CIED procedure or removal code; or 2) CIED procedure code along with systemic infection. Patient health profile was evaluated …

Lead-Associated Endocarditis: The Important Role Of Methicillin-Resistant Staphylococcus Aureus., Arnold J. Greenspon, Eugene S. Rhim, George Mark, Joseph Desimone, Reginald T. Ho

Division of Cardiology Faculty Papers

BACKGROUND: Infection is a potentially life-threatening complication of cardiac device implantation. Lead-associated endocarditis (LAE) may be the most serious complication since it is associated with a high mortality. METHODS: The medical records of patients referred to our institution for the treatment of LAE between 1999 and 2007 were reviewed. RESULTS: A total of 51 of 107 patients referred for device-related infections met the criteria for LAE. Of these, 19 occurred within 6 months of their most recent procedure (early), while the remaining 32 occurred more than 6 months later (mean = 31.9 months post procedure). Devices included pacemakers in 33 …