[Polypous endocarditis of the tricuspid valve. The morphological changes in the heart and lung in one case].

S Nachev, R Takov
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Abstract

A case of polypous endocarditis which affects the tricuspid valve and whose genesis remains unclear (a septic state, an idiopathic disease?) is described. Clinically the disease has taken its course as a chronically recurring form of pulmonary thromboembolism. Morphologically it concerns to a massive fibroplastic verrucous endocarditis of the tricuspid valve and a more slightly expressed similar process in the wall of the right atrium and ventricle, combined with a significant fibrosis of the myocardium. The death has come from a massive thrombotic embolism in the two branches of the pulmonary artery on the background of a great number of small thromboembolic and hemorrhagenic infarctions with a different duration in the two lobes of the lung, which lead to an adaptable reconstruction of many lung vessels. The presence of a discrete affection of the aortic valve according to a rheumatic type and the combination of the disease, in the described case, with essential hypertension and thrombophlebitis undergone in the past, give a reason to discuss the possibility of taking into account these diseases in etiopathogenesis of the described myocardiopathy.

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三尖瓣息肉性心内膜炎。心、肺各1例形态学改变[d]。
一例影响三尖瓣的息肉性心内膜炎,其发生原因尚不清楚(脓毒性状态,特发性疾病?)临床上该病已采取其病程作为慢性复发形式的肺血栓栓塞。形态学表现为三尖瓣的大量纤维增生疣状心内膜炎,右心房和心室壁也有类似的轻微表现,并伴有明显的心肌纤维化。死亡是由于肺动脉两个分支的大量血栓栓塞,其背景是在肺的两个叶中有大量的小血栓栓塞和出血性梗死,其持续时间不同,这导致许多肺血管的适应性重建。根据风湿病类型和所述病例中与过去经历的原发性高血压和血栓性静脉炎相结合的疾病的存在对主动脉瓣的离散影响,有理由讨论在所述心肌病的发病机制中考虑这些疾病的可能性。
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