Abstract:
:Bacterial infections of the heart in compromised patients are uncommon but may be increasing in relative frequency. They are associated with near-equal frequencies in patients who have pre-existing or simultaneous infections at other sites, patients with neoplasms (usually solid tumors), those who have undergone cardiac surgery, and intravenous drug or ethanol abusers. Staphylococcus aureus is the bacteria most often identified, in contrast to a preponderance of Streptococcus isolated in the pre- and early antibiotic era. Gram-negative bacilli are the causative organisms in a significant number of cases. The endocardium remains the most common site of infection, and left-sided valves are most commonly involved, especially the mitral valve, often in the absence of pre-existing valvular damage. The majority of cases are associated with involvement at other sites, and premortem blood cultures are positive in approximately two thirds of patients who undergo autopsy. Fungal infections involving the heart do not occur as often as bacterial infections. The frequency, however, is increasing. Fungal infections usually occur in patients who have received treatment with antineoplastic agents, antibiotics, or corticosteroids, alone or in combination, or who have had abdominal or cardiac surgery. Candida is the organism found most frequently and usually causes myocarditis or endocarditis, whereas Aspergillus involves the myocardium but may be invasive to the endocardium or pericardium. Other fungi that occasionally infect the heart include Phycomycetes and Cryptococcus. Dissemination is usually present and involves the lungs, kidneys, brain, or gastrointestinal tract. The diagnosis may be difficult prior to death, because blood cultures are positive in only one third of patients who come to autopsy. Precipitin tests and antibody titers for specific organisms may be helpful in providing early diagnosis. Survival rates can be improved by early diagnosis and the institution of aggressive antifungal treatment.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Atkinson JB,Robinowitz M,McAllister HA Jr,Forman MB,Virmani Rsubject
Has Abstractpub_date
1984-11-01 00:00:00pages
671-86issue
4eissn
0733-8651issn
1558-2264journal_volume
2pub_type
杂志文章abstract::In the past, much attention in imaging research was focused on the macroscopic morphology and patency of arteries. Only recently, research and clinical interest have shifted to the microcirculation and its impact on the long-term prognosis in patients with vascular diseases. This focus and newly developed therapeutic ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(03)00110-3
更新日期:2003-11-01 00:00:00
abstract::Assessment of HRV through time domain variables is a simple and practical method of assessing autonomic function. In this capacity its utility has been demonstrated in normal subjects and in diverse cardiac and noncardiac pathologic states. It can be used to assess the effects of drugs and other interventions, includi...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::The fundamental requirements for a meaningful biomarker have not been met in the prediction of the aneurysm trait, the progression of the aneurysm disease state, or the prevention of catastrophic aortic complications. Aortic aneurysm is a worthy opponent on all fronts, and clinicians should continue actively to evalua...
journal_title:Cardiology clinics
pub_type: 评论,杂志文章,评审
doi:10.1016/j.ccl.2010.01.018
更新日期:2010-05-01 00:00:00
abstract::Over the past several decades there has been enormous progress in the understanding of many electrophysiologic characteristics of the AVNRT circuit. Although a great number of questions have been resolved, several pertinent issues require further investigation. Medical treatment remains the most widely used therapeuti...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-02-01 00:00:00
abstract::Initially, transcatheter aortic valve replacement (TAVR) was only used in patients with severe symptomatic aortic stenosis and prohibitive risk for surgical aortic valve replacement. Subsequently, TAVR was extended to patients with high and intermediate surgical risk. Recently, the results of randomized trials in low-...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2019.09.007
更新日期:2020-02-01 00:00:00
abstract::Thoracoabdominal aortic aneurysms are increasing in incidence. Rupture is associated with a high rate of morbidity and mortality. The historic gold standard of open repair can be performed with low rates of complications at centers of excellence. However, these results are not universally achievable, with significantl...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.03.008
更新日期:2017-08-01 00:00:00
abstract::Until recently, catheter-based radiofrequency ablation for atrial fibrillation was limited to palliative approaches of either atrioventricular node ablation or modification. It is now recognized that at least a proportion of patients with paroxysmal atrial fibrillation may be suitable for curative ablation of an under...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70371-4
更新日期:1997-11-01 00:00:00
abstract::Implantable cardioverter-defibrillators (ICDs) improve survival in patients who have left ventricular dysfunction; however, they are associated with numerous problems at implant and during follow-up. The diagnosis and management of these problems is usually straightforward, but more difficult problems may include the ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2008.03.012
更新日期:2008-08-01 00:00:00
abstract::Heart-kidney interactions have been increasingly recognized by clinicians and researchers who study and treat heart failure and kidney disease. A classification system has been developed to categorize the different manifestations of cardiac and renal dysfunction. Work has highlighted the significant negative prognosti...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2010.04.004
更新日期:2010-08-01 00:00:00
abstract::The merits of Holter monitor recording, intermittent event recording, and transtelephonic recording are stated, the equipment used for each method is described, and the type of data obtained is analyzed. ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::Subaortic stenosis can be a complex disease of multiple anatomic etiologies. At the core is either an elongated and narrow outflow tract as compared to normal or a fully muscle-rimmed VSD used as an intraventricular routing pathway. An array of treatment modalities is needed for an effective management strategy. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(02)00013-9
更新日期:2002-08-01 00:00:00
abstract::The noninvasive assessment of patients who present with syncope is based on a thorough, complete history and physical examination. The history requires close attention to precipitating events and the description of the spell. Often, patients are poor historians with regard to symptoms leading up to and following the e...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70330-1
更新日期:1997-05-01 00:00:00
abstract::Hypertrophic cardiomyopathy is a genetic heart disease with heterogeneous clinical features, including progression to advanced heart failure. The development of these symptoms can be related to outflow obstruction but in some patients reflects an underlying process of fibrosis and progressive ventricular dysfunction. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2018.08.007
更新日期:2019-02-01 00:00:00
abstract::Occlusion of the left atrial appendage (LAA) may reduce the risk of stroke in patients with atrial fibrillation (AF). Trials comparing LAA occlusion to warfarin anticoagulation in patients with nonvalvular AF showed a reduction in hemorrhagic stroke, although an increase in safety events due to procedural complication...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2013.05.008
更新日期:2013-08-01 00:00:00
abstract::Mechanical circulatory support using left ventricular assist devices (LVAD) has become an accepted mode of therapy for both bridging patients with end-stage heart failure to transplant and as a destination therapy. Right ventricular (RV) dysfunction is common after LVAD insertion and is a significant source of morbidi...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:10.1016/j.ccl.2011.08.011
更新日期:2011-11-01 00:00:00
abstract::Coronary thrombosis is now recognized as the most common proximate cause of acute myocardial infarction, and thrombolysis is evolving as an accepted therapeutic approach to patients presenting in the early stages of myocardial infarction. The ascent of thrombolysis in treatment hierarchies reflects multiple factors, i...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-02-01 00:00:00
abstract::Coronary computed tomographic angiography (CTA) is a promising noninvasive tool that allows the visualization of plaque morphology. Plaques characterized by positive remodeling, low attenuation, and napkin ring circular enhancement on contrast-enhanced coronary CTA have been regarded as rupture-prone vulnerable plaque...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:10.1016/j.ccl.2011.10.002
更新日期:2012-02-01 00:00:00
abstract::Ebstein anomaly is a congenital malformation involving primarily the tricuspid valve, with failure of delamination from the underlying myocardium and right ventricular myopathy. Echocardiography is diagnostic in most patients and demonstrates apical displacement of the septal leaflet and variable tethering of leaflet ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2020.04.004
更新日期:2020-08-01 00:00:00
abstract::Myocardial systolic contractile dysfunction can occur despite preservation of myocardial viability, conditions referred to as myocardial 'stunning' or 'hibernation.' Because simple assessment of wall motion does not adequately distinguish nonviable from viable but noncontracting myocardial regions, clinicians require ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::High-density lipoproteins (HDLs) have presented an attractive target for development of new therapies for cardiovascular prevention on the basis of epidemiology and preclinical studies demonstrating their protective properties. Development of HDL mimetics provides an opportunity to administer functional HDL. However, ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.12.012
更新日期:2018-05-01 00:00:00
abstract::This article reviews the definition, locations, and pathogenesis of acute myocardial infarction and provides a review of the pathology of acute reperfusion therapy. Various complications and sequelae of acute myocardial infarction are also surveyed. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-02-01 00:00:00
abstract::Hypertensive crises, which include hypertensive emergencies and urgencies, are frequently encountered in the emergency department, and require immediate attention as they can lead to irreversible end-organ damage. Normal blood pressure (BP) regulation is altered during acute rises in BP, leading to end-organ damage. M...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.07.011
更新日期:2012-11-01 00:00:00
abstract::Clinical trial results support the aggressive use of anticoagulant therapy to prevent systemic embolism in patients with acute myocardial infarction who are at high risk for embolism (e.g., anterior transmural infarction). Other patients at risk for systemic embolism include those with chronic left ventricular aneurys...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-08-01 00:00:00
abstract::One of the major drivers of change in the practice of cardiology is population change. This article discusses the current debate about epidemiologic transition paired with other ongoing transitions with direct relevance to cardiovascular conditions. Challenges specific to patterns of risk factors over time; readiness ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2016.08.004
更新日期:2017-02-01 00:00:00
abstract::Stress-first approaches to myocardial perfusion imaging provide diagnostically and prognostically accurate perfusion data equivalent to a full rest-stress study, save time in the imaging laboratory, and reduce the radiation exposure to patients and laboratory staff. Converting a nuclear cardiology laboratory from a co...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2015.06.006
更新日期:2016-02-01 00:00:00
abstract::In this era of interventional electrophysiology, the accuracy of the electrocardiogram in diagnosis of supraventricular tachycardia could be improved by detailed endocardial mapping and confirmed by results of radiofrequency catheter ablation. This article describes the electrocardiographic characteristics for differe...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70361-1
更新日期:1997-11-01 00:00:00
abstract::Valvular heart disease (VHD) is generally well tolerated during pregnancy; however, the dramatic changes in hemodynamics that occur during pregnancy can lead to clinical decompensation in high-risk women. Women with VHD considering pregnancy should undergo preconception counseling with a high-risk obstetrician and car...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2020.09.010
更新日期:2021-02-01 00:00:00
abstract::Atrial fibrillation (AF), an escalating dysrhythmia, is accountable for extensive population morbidity and mortality. In the United States, approximately 2.3 million people are presently diagnosed with AF and it is estimated that this prevalence may increase to 5.6 million by 2050. Foremost predisposing risk factors f...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2008.09.015
更新日期:2009-02-01 00:00:00
abstract::Sudden death, a major cause of mortality in the Western world, usually results from electrophysiologic phenomena in chronically damaged hearts with advanced coronary atherosclerosis. The exact pathophysiologic mechanisms are not known, but there is reasonable circumstantial evidence to implicate myocardial ischemia--c...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Patients who have chest pain following the use of cocaine have become more common in emergency departments throughout the United States,with approximately 6% of these patients sustaining an acute MI. The authors have described the rationale for recommending aspirin, benzodiaze-pines, and nitroglycerin as first-line tr...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2005.09.003
更新日期:2006-02-01 00:00:00