Related Experiment Video

Updated: May 29, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Hemorrhagic transformation of ischemic stroke: severe complications of prosthetic valve endocarditis

Jin-Sun Kim1, Woo-In Yang, Chi Young Shim

  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Korean Circulation Journal
|September 28, 2011
PubMed

Insights

Infective endocarditis (IE) can cause ischemic stroke, with anticoagulation risking hemorrhagic transformation (HT). This study found HT occurred in 13.8% of prosthetic valve endocarditis cases, even with subtherapeutic anticoagulation.

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Ischemic stroke is a frequent complication of infective endocarditis (IE), affecting 20-40% of left-sided IE cases.
  • Anticoagulation therapy in IE patients with ischemic stroke poses a risk of hemorrhagic transformation (HT), worsening clinical outcomes.
  • Managing anticoagulation in IE with mechanical prosthetic valves presents a dilemma due to thrombotic risks.

Purpose of the Study:

  • To investigate the incidence and circumstances of hemorrhagic transformation (HT) in ischemic stroke among patients with prosthetic valve endocarditis (PVE).

Main Methods:

  • Retrospective review of patients with prosthetic valve endocarditis (PVE) and ischemic stroke.
  • Analysis of anticoagulation status, including prothrombin time (PT) ranges, in relation to HT development.

Main Results:

  • Hemorrhagic transformation (HT) occurred in 13.8% (4/29) of ischemic stroke cases in prosthetic valve endocarditis (PVE).
  • HT events were observed across various clinical scenarios.
  • Some HT cases arose even in patients with subtherapeutic prothrombin time (PT) levels.

Conclusions:

  • Hemorrhagic transformation (HT) is a significant complication of ischemic stroke in prosthetic valve endocarditis (PVE).
  • The risk of HT exists even with suboptimal anticoagulation, highlighting the complexity of managing these patients.

Keywords:
AnticoagulantsCerebral hemorrhageEndocarditisHeart valve prosthesisStroke

More Related Videos

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...