10例感染性心内膜炎的临床和超声心动图分析

CLINICAL AND ECHOCARDIOGRAPHIC EXAMINATION OF 10 CASES OF INFECTIVE ENDOCARDITIS

本文对10例感染性心内膜炎的超声心动图作一分析和探讨。10例的M型超声心动图和扇形实时显像检查均能检出附着在瓣膜和/或腱索上的赘生物,并能估计其大小。赘生物较大的4例中,3例出现栓塞症状,3例出现连枷状主动脉瓣,2例二尖瓣和腱索受累者亦出现连枷状瓣膜。2例在6月后随访中发现赘生物大小无明显改变。

Seven cases of rheumatic aortic and mitral valvular disease,one each of congenital ventricular septal defect and aortic stenosis,and one of mitral valve prolapse were infected with bacterial endocarditis.Echocardiographic examination was performed in all.Only 2 cases showed positive blood culture,Streptococcus viridans and Staphylococcus aureus respectively,but M-mode and two dimensional real-time biplane cross-sectional echocardiographic examination revealed valvular vegetations in all.The size of vegetations also could be estimated.Large vegetations were observed in 4,3 of them suffered from embolic episodes,and 3 resulted in flail aortic valves.Both the mitral valve and chordae involved in 2 cases also presented flail valve leaflet.No change in size of vegetations was noted in 2 after 6 mo.It is concluded that the echocardiography is a simple and precise non-invasive method in the diagnosis of infective endocarditits.