Pub Date : 2021-07-27DOI: 10.5772/intechopen.96909
A. Benedicto, L. Domínguez
The growing number of electronic intracardiac devices (pacemakers, resynchronizers and defibrillators) and non-electronic devices (percutaneous occluders) implanted, combined with certain common characteristics in the treated population (underlying heart disease, advanced age, kidney disease, multiple associated pathologies), have led to a change in the spectrum of presentation of endocarditis, with an increase in cases related to these devices. These infections pose diagnostic and therapeutic challenges due to the complexity of the patients, the microorganisms involved –who frequently generate the formation of biofilm- and the percutaneous or surgical techniques involved in the removal of material. All these circumstances require a multidisciplinary approach.
{"title":"Endocarditis and Cardiac Device Infections","authors":"A. Benedicto, L. Domínguez","doi":"10.5772/intechopen.96909","DOIUrl":"https://doi.org/10.5772/intechopen.96909","url":null,"abstract":"The growing number of electronic intracardiac devices (pacemakers, resynchronizers and defibrillators) and non-electronic devices (percutaneous occluders) implanted, combined with certain common characteristics in the treated population (underlying heart disease, advanced age, kidney disease, multiple associated pathologies), have led to a change in the spectrum of presentation of endocarditis, with an increase in cases related to these devices. These infections pose diagnostic and therapeutic challenges due to the complexity of the patients, the microorganisms involved –who frequently generate the formation of biofilm- and the percutaneous or surgical techniques involved in the removal of material. All these circumstances require a multidisciplinary approach.","PeriodicalId":447408,"journal":{"name":"Advanced Concepts in Endocarditis - 2021","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128407122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-28DOI: 10.5772/INTECHOPEN.95434
Vira Ayzenbart, M. Joseph
The current treatment paradigm for right sided infective endocarditis is rapidly evolving. The existing recommendations for right sided infective endocarditis include medical therapy with surgical therapy used in certain situations. Surgical therapy is based on the size of the vegetation, presence of infective complications and certain causative organisms as well the retention of intracardiac devices. Unfortunately, medical therapy alone is usually not enough to clear the infection, especially when intravenous drug use is associated as the etiology. Intravenous drug use is associated with a high rate of recidivism in tricuspid valve endocarditis. Even with indications for surgery, these patients present an ethical dilemma as most of these patients will re-infect their valves post-surgery. This often provides little option than for the surgeon to re-operate in a setting with a higher risk of mortality and morbidity. We present an evolving technique of percutaneous extirpation of vegetation, allowing for rapid clearance of endocarditis, less chance of failure of medical therapy with a lower risk profile for complication.
{"title":"Contemporary and Evolving Treatment of Tricuspid Endocarditis","authors":"Vira Ayzenbart, M. Joseph","doi":"10.5772/INTECHOPEN.95434","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.95434","url":null,"abstract":"The current treatment paradigm for right sided infective endocarditis is rapidly evolving. The existing recommendations for right sided infective endocarditis include medical therapy with surgical therapy used in certain situations. Surgical therapy is based on the size of the vegetation, presence of infective complications and certain causative organisms as well the retention of intracardiac devices. Unfortunately, medical therapy alone is usually not enough to clear the infection, especially when intravenous drug use is associated as the etiology. Intravenous drug use is associated with a high rate of recidivism in tricuspid valve endocarditis. Even with indications for surgery, these patients present an ethical dilemma as most of these patients will re-infect their valves post-surgery. This often provides little option than for the surgeon to re-operate in a setting with a higher risk of mortality and morbidity. We present an evolving technique of percutaneous extirpation of vegetation, allowing for rapid clearance of endocarditis, less chance of failure of medical therapy with a lower risk profile for complication.","PeriodicalId":447408,"journal":{"name":"Advanced Concepts in Endocarditis - 2021","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132976922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-11DOI: 10.5772/INTECHOPEN.95365
Sameh M. Said
Tricuspid valve endocarditis (TVE) continues to be on the rise and has been mostly attributed to the growing epidemic of intravenous drug abuse (IVDA). Other risk factors include long-term indwelling central venous catheters and implantable cardiac devices. While medical management continues to be the first line therapy, surgery is indicated when medical management fails, and in the presence of hemodynamic deterioration, recurrent septic pulmonary embolization and/or persistent sepsis. Tricuspid valve (TV) excision once was the main surgical strategy, but other options include TV repair/reconstruction and replacement. Remaining challenges include management of drug-induced endocarditis and the best strategy for recurrent infection.
{"title":"Surgery for Tricuspid Valve Endocarditis in the Current Era","authors":"Sameh M. Said","doi":"10.5772/INTECHOPEN.95365","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.95365","url":null,"abstract":"Tricuspid valve endocarditis (TVE) continues to be on the rise and has been mostly attributed to the growing epidemic of intravenous drug abuse (IVDA). Other risk factors include long-term indwelling central venous catheters and implantable cardiac devices. While medical management continues to be the first line therapy, surgery is indicated when medical management fails, and in the presence of hemodynamic deterioration, recurrent septic pulmonary embolization and/or persistent sepsis. Tricuspid valve (TV) excision once was the main surgical strategy, but other options include TV repair/reconstruction and replacement. Remaining challenges include management of drug-induced endocarditis and the best strategy for recurrent infection.","PeriodicalId":447408,"journal":{"name":"Advanced Concepts in Endocarditis - 2021","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133246460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-04DOI: 10.5772/INTECHOPEN.95378
L. García-Álvarez, J. Oteo
Tropheryma whipplei mainly known as the causative agent of classical Whipple’s disease, also produces acute, sub-acute and chronic localized forms of infection such as endocarditis. The development of molecular tools has allowed increasing the number of cases of endocarditis due to blood culture use to be negative in T. whipplei endocarditis and most of the cases are confirmed post-surgery when molecular analyses of heart valves are performed. Although, T. whipplei endocarditis is an uncommon condition with an atypical presentation it must be considered in the diagnosis of blood culture negative endocarditis and in patients with heart failure in which valve affectation is present. Other clinical features such as long lasting arthralgia can be present in a high percentage of the patients. It is important to know that few cases are diagnosed in the context of the classical Whipple’s disease. The prognosis is very good when an appropriate surgical management and antimicrobial-specific treatment is given. This chapter describes the epidemiological, clinical characteristics, diagnosis and treatments for T. whipplei endocarditis.
{"title":"Tropheryma whipplei Endocarditis","authors":"L. García-Álvarez, J. Oteo","doi":"10.5772/INTECHOPEN.95378","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.95378","url":null,"abstract":"Tropheryma whipplei mainly known as the causative agent of classical Whipple’s disease, also produces acute, sub-acute and chronic localized forms of infection such as endocarditis. The development of molecular tools has allowed increasing the number of cases of endocarditis due to blood culture use to be negative in T. whipplei endocarditis and most of the cases are confirmed post-surgery when molecular analyses of heart valves are performed. Although, T. whipplei endocarditis is an uncommon condition with an atypical presentation it must be considered in the diagnosis of blood culture negative endocarditis and in patients with heart failure in which valve affectation is present. Other clinical features such as long lasting arthralgia can be present in a high percentage of the patients. It is important to know that few cases are diagnosed in the context of the classical Whipple’s disease. The prognosis is very good when an appropriate surgical management and antimicrobial-specific treatment is given. This chapter describes the epidemiological, clinical characteristics, diagnosis and treatments for T. whipplei endocarditis.","PeriodicalId":447408,"journal":{"name":"Advanced Concepts in Endocarditis - 2021","volume":"204 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122587373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.5772/intechopen.93002
Eric J. Stöhr, T. Samuel
The human heart is an asymmetrical structure that consists of oblique, circumferential, and transmural fibers, as well as laminae and sheets. Sequential electrical activation of all the muscle fibers ultimately results in a coordinated contraction of the heart muscle also referred to as “deformation.” This is immediately followed by myocardial relaxation, when the preceding deformation is reversed, and the ventricles fill with blood. Given the complexity of these repetitive motions, it is not surprising that there is great diversity in the myocardial deformation between different individuals and between distinct populations. Exercise presents a natural challenge to determine the full capacity of an individual’s heart, and modern imaging technologies allow for the non-invasive assessment of myocardial deformation during exercise. In this chapter, the most relevant anatomical basis for myocardial deformation is summarized and definitions of the most relevant parameters are provided. Then, the general cardiac responses to exercise are highlighted before the current knowledge on myocardial deformation during exercise is discussed. The literature clearly indicates that the echocardiographic evaluation of myocardial deformation during exercise holds great promise for the identification of sub-clinical disease. Future studies should aim to determine the mechanisms of differential expression of myocardial deformation during exercise in health and disease.
{"title":"Echocardiographic Assessment of Myocardial Deformation during Exercise","authors":"Eric J. Stöhr, T. Samuel","doi":"10.5772/intechopen.93002","DOIUrl":"https://doi.org/10.5772/intechopen.93002","url":null,"abstract":"The human heart is an asymmetrical structure that consists of oblique, circumferential, and transmural fibers, as well as laminae and sheets. Sequential electrical activation of all the muscle fibers ultimately results in a coordinated contraction of the heart muscle also referred to as “deformation.” This is immediately followed by myocardial relaxation, when the preceding deformation is reversed, and the ventricles fill with blood. Given the complexity of these repetitive motions, it is not surprising that there is great diversity in the myocardial deformation between different individuals and between distinct populations. Exercise presents a natural challenge to determine the full capacity of an individual’s heart, and modern imaging technologies allow for the non-invasive assessment of myocardial deformation during exercise. In this chapter, the most relevant anatomical basis for myocardial deformation is summarized and definitions of the most relevant parameters are provided. Then, the general cardiac responses to exercise are highlighted before the current knowledge on myocardial deformation during exercise is discussed. The literature clearly indicates that the echocardiographic evaluation of myocardial deformation during exercise holds great promise for the identification of sub-clinical disease. Future studies should aim to determine the mechanisms of differential expression of myocardial deformation during exercise in health and disease.","PeriodicalId":447408,"journal":{"name":"Advanced Concepts in Endocarditis - 2021","volume":"149 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115095644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-25DOI: 10.5772/INTECHOPEN.93085
T. Ntoskas
Cardio-oncology is a rapidly emerging medical field that focusses on the improvement of the quality of life of cancer patients by preventing and treating the adverse cardiovascular complications of cancer therapy. Early recognition of cancer therapy-related cardiac dysfunction (CTRCD) provides an opportunity to mitigate cardiac injury and risk of developing late cardiac events. Cardiac imaging, and in particular, transthoracic echocardiography, plays an essential role in the baseline assessment, the detection and the surveillance of CRTCD in patients during and after the cancer therapy. Although the frequency of screening for the cardiotoxicity in patients undergoing active treatments and cancer survivors remains a topic of debate and ongoing research, echocardiography continues to be the leader for continuous monitoring by imaging due to the wide availability, lack of exposure to radiation, ability to recognise the effects on cardiac function and assess haemodynamics and other cardiac structures. The cardiac imaging applied to cardio-oncology includes standard and advanced (speckle tracking and three-dimensional (3D)) echocardiography.
{"title":"Cardio-Oncology: The Role of Echocardiography in Cancer Patients","authors":"T. Ntoskas","doi":"10.5772/INTECHOPEN.93085","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.93085","url":null,"abstract":"Cardio-oncology is a rapidly emerging medical field that focusses on the improvement of the quality of life of cancer patients by preventing and treating the adverse cardiovascular complications of cancer therapy. Early recognition of cancer therapy-related cardiac dysfunction (CTRCD) provides an opportunity to mitigate cardiac injury and risk of developing late cardiac events. Cardiac imaging, and in particular, transthoracic echocardiography, plays an essential role in the baseline assessment, the detection and the surveillance of CRTCD in patients during and after the cancer therapy. Although the frequency of screening for the cardiotoxicity in patients undergoing active treatments and cancer survivors remains a topic of debate and ongoing research, echocardiography continues to be the leader for continuous monitoring by imaging due to the wide availability, lack of exposure to radiation, ability to recognise the effects on cardiac function and assess haemodynamics and other cardiac structures. The cardiac imaging applied to cardio-oncology includes standard and advanced (speckle tracking and three-dimensional (3D)) echocardiography.","PeriodicalId":447408,"journal":{"name":"Advanced Concepts in Endocarditis - 2021","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133167049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-05DOI: 10.5772/INTECHOPEN.91867
M. Routhu, G. Krishna
In this chapter, the normal anatomy of the heart as well as pathologic cases is consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia/absent pulmonary valve syndrome, aortic malformation, hypoplastic left heart, conotruncal anomalies/common arterial trunk, tricuspid dysplasia, Ebstein anomaly, univentricular heart, and systemic venous abnormalities among other congenital cardio vascular defects by ultrasound images. Anatomical details of most CHD in fetus were provided by two-dimensional (2D) ultrasound with higher quality imaging, which enhances the diagnostic accuracy in a variety of CHD.
{"title":"Fetal Echocardiogram Normal and Abnormal","authors":"M. Routhu, G. Krishna","doi":"10.5772/INTECHOPEN.91867","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.91867","url":null,"abstract":"In this chapter, the normal anatomy of the heart as well as pathologic cases is consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia/absent pulmonary valve syndrome, aortic malformation, hypoplastic left heart, conotruncal anomalies/common arterial trunk, tricuspid dysplasia, Ebstein anomaly, univentricular heart, and systemic venous abnormalities among other congenital cardio vascular defects by ultrasound images. Anatomical details of most CHD in fetus were provided by two-dimensional (2D) ultrasound with higher quality imaging, which enhances the diagnostic accuracy in a variety of CHD.","PeriodicalId":447408,"journal":{"name":"Advanced Concepts in Endocarditis - 2021","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126488868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-20DOI: 10.5772/intechopen.91819
S. Suh, Ta-Li Lu, R. Choi, C. Hyun
Myxomatous mitral valve disease (MMVD) is the most common heart disease in dogs and has many similarities to human mitral valve prolapse (MVP). Transthoracic echocardiography is a non-invasive method for making a diagnosis and predicting the progression of heart failure (HF) in dogs and humans with mitral regurgitation (MR). It enables clinicians to detect the mitral valve (MV) lesions, to evaluate MR severity, and to assess its impact on cardiac remodeling, myocardial function, left ventricular (LV) filling pressures, as well as pulmonary arterial pressure. Furthermore, advanced ultrasound technologies such as tissue Doppler imaging (TDI), strain and strain rate imaging, and two-dimensional (2D) speckle tracking echocardiography (STE) provide a better assessment of global and regional myocardial function. Although the severity of MR and HF in dogs with MMVD is being evaluated as similar to human cardiology, the veterinary cardiologists are more focused on the severity of cardiac remodeling and cardiac dysfunction caused by MR, because surgical restoration of defected mitral apparatus is rarely done in dogs. The chapter will review conventional echocardiographic features of MMVD in dogs to provide a better understanding of the similarities and discrepancies between canine MMVD and human MVP to veterinary and human cardiologists and researchers.
{"title":"Echocardiographic Features in Canine Myxomatous Mitral Valve Disease: An Animal Model for Human Mitral Valve Prolapse","authors":"S. Suh, Ta-Li Lu, R. Choi, C. Hyun","doi":"10.5772/intechopen.91819","DOIUrl":"https://doi.org/10.5772/intechopen.91819","url":null,"abstract":"Myxomatous mitral valve disease (MMVD) is the most common heart disease in dogs and has many similarities to human mitral valve prolapse (MVP). Transthoracic echocardiography is a non-invasive method for making a diagnosis and predicting the progression of heart failure (HF) in dogs and humans with mitral regurgitation (MR). It enables clinicians to detect the mitral valve (MV) lesions, to evaluate MR severity, and to assess its impact on cardiac remodeling, myocardial function, left ventricular (LV) filling pressures, as well as pulmonary arterial pressure. Furthermore, advanced ultrasound technologies such as tissue Doppler imaging (TDI), strain and strain rate imaging, and two-dimensional (2D) speckle tracking echocardiography (STE) provide a better assessment of global and regional myocardial function. Although the severity of MR and HF in dogs with MMVD is being evaluated as similar to human cardiology, the veterinary cardiologists are more focused on the severity of cardiac remodeling and cardiac dysfunction caused by MR, because surgical restoration of defected mitral apparatus is rarely done in dogs. The chapter will review conventional echocardiographic features of MMVD in dogs to provide a better understanding of the similarities and discrepancies between canine MMVD and human MVP to veterinary and human cardiologists and researchers.","PeriodicalId":447408,"journal":{"name":"Advanced Concepts in Endocarditis - 2021","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130960794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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