<症例>感染性心内膜炎の一症例 : 特に心エコー図によるVegetation検出の意義について

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The vegetation of infective endocarditis can be found by echocardiogram. Many reports described that these echocardiographically detectable vegetations might change in size and shape during the clinical courses. However, there are no agreements on the clinical significance of the changes of vegetation. We studied the echocardiographic features of 17 patients with infective endocarditis in relation to their clinical courses. Of 8 patients in whom vegetation was found echocardiographically, 6 showed enlargement and/or collapse of vegetation during the course. In one of these 8 cases, vegetation diminished as she was clinically cured. The remaining one died of acute heart failure and his echocardiographic change was indistinct. Of the 6 patients who showed enlargement and/or collapse of vegetation, 4 underwent valve replacement, one died of acute heart failure and cerebral embolism before surgery and the remaining one was medically cured. The last case, a 78 years old woman, was discussed in detail in this paper, because she had a long clinical course with a relapse and echocardiographic observations on vegetation were made. In summary, there were greater major complications in the patients with vegetation on echocardiogram, while in the patients without detectable vegetation there were less complications. It is considered that the detection of vegetation on echocardiogram is an ominous sign which might eventually necessitates surgical intervention, and also the enlargement of vegetation suggests a poor prognosis and the diminution of vegetation does not necessarily indicate the healing process but might be a sign of valve destruction.
近畿大学の論文
1984-06-25

<症例>感染性心内膜炎の一症例 : 特に心エコー図によるVegetation検出の意義について

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