[Pulmonary valve endocarditis and atrial fibrillation]. Dtsch Med Wochenschr 1993 Jul 02;118(26):975-8
Date
07/02/1993Pubmed ID
8519232DOI
10.1055/s-2008-1059415Scopus ID
2-s2.0-0027300495 (requires institutional sign-in at Scopus site) 1 CitationAbstract
A 61-year-old man became ill with a fever of 39.4 degrees C, decreased exercise tolerance and headache as well as chest pain. Physical examination 3 weeks after the onset of symptoms merely revealed irregular heart rate at 100 beats/min. Erythrocyte sedimentation rate was increased (30/61 mm), as were serum bilirubin, lactate dehydrogenase, alkaline phosphatase, gamma-GT and C-reactive protein. The ECG showed atrial fibrillation with a rapid and irregular ventricular rate, as well as ventricular extrasystoles (Lown type IIIA), there were no abnormal findings on either the chest radiography or transthoracic echocardiography. Antiarrhythmic treatment brought about atrial flutter with 4:1 a-v conduction. Transoesophageal echocardiography now revealed vegetation on the pulmonary valve and microthrombi in the left atrial appendage. Ten days after starting intravenous penicillin G (10 mega units four times daily), gentamycin (60 mg three times daily) and heparin (30,000 units over 24 h) sinus rhythm was restored, the vegetation had got smaller and no thrombi were demonstrated. After 27 days antibiotic treatment was changed to oral penicillin V. After 4 weeks the patient was discharged symptom-free.
Author List
Harder D, Ehses W, Weller P, Deuss U, Winkelmann WMESH terms used to index this publication - Major topics in bold
Atrial FibrillationEchocardiography
Electrocardiography
Endocarditis, Bacterial
Gentamicins
Heparin
Humans
Male
Middle Aged
Penicillin G
Penicillin V
Streptococcal Infections
