كليدواژه :
آندوكارديت , دريچه طبيعي , Endocarditis , بيماران قلبي , Cardiac patients , Mitral valve , پزشكي
چكيده لاتين :
Background and Objectives: Infectious endocarditis is a disease caused by microbial infection of the endothelium which covers the heart. Its special is microbial vegetation which usually appear on the valves and sometimes it may be seen in the interior layers of the heart. Different studies in advanced countries have reported the outbreak of the disease from 1.6 to 6 in 100,000 patients. The present study was conducted on cardiac patients to diagnose those suffering from native valve endocarditis and to assess them clinically as well as bacteriologically.
Materials and Methods: This retrospective analysis was conducted in Shahid Madani Hospital of Tabriz, during the year 1995 - 1999. The patients who lacked diagnostic symptom of endocarditis, and those who were diagnosed only on the basis of clinical signs, were excluded from the study and finally 20 patients who had endocarditis of native valve were studied. The information was collected by filling a questionnaire including demographic information, blood samplings, pathologic results, reports of echocardiography and radiology, feverish syndrome, the records of using antibiotics and the signs of disease. These informations were analyzed by the statistical program of SPSS WIN.
Results: In total 20 patients with average age of 34 years, having native valve endocarditis were selected for the study. Of these patients 65^o were male and 35% were female. Out of twenty patients, 17 had complete results of their blood culture test. Staphylococcus aureus was obtained in 11.67% cases and two cases were positive for beta-hemolytic Streptococcus (11.72%). In the analysis of cardiac complication none of them had myocardial infarction and angina, 6 cases had embolism, 10% had arrhythmias and other 10% patients had heart block, 3 of the patients had neurologic lesions and radiological findings in 9 cases were abnormal. Out of 20 , 11 patients underwent open heart surgery. The patients were treated with ampicillin and gentamicin postoperatively. The minimum duration of confinement to bed was 6 days and the maximum 9 days. In this study 80% of the patients recovered while 20% died. Three patients had Brucella sp. endocarditis which was recognized by the Wright test. The most common site of the infection was aorta.
Conclusion: Rheumatic fever is a universal disease, the outbreak of which is very high in the countries which have poor economical conditions, are overpopulated and having substandard living conditions. These conditions cause the rapid transmission of rheumatogenic streptococcus. Improving these conditions and usage of proper and timely antimicrobial treatment can decrease prevalence of rheumatic fever and endocarditis too.
