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Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

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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...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

929
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...
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Aneurysm I: Introduction01:30

Aneurysm I: Introduction

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

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Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
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Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

478
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...
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Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

360
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...
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Multimodality Diagnosis of Mesenteric Ischemia
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Infective endocarditis associated superior mesenteric artery pseudoaneurysm.

Pedro G Teixeira1, Eli Thompson1, Sarah Wartman1

  • 1Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles, CA.

Annals of Vascular Surgery
|April 8, 2014
PubMed
Summary

Mycotic aneurysms of the superior mesenteric artery (SMA) linked to infective endocarditis are rare but dangerous. Prompt surgical intervention for SMA pseudoaneurysms (PAs) is crucial to prevent rupture and improve patient outcomes.

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Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Mycotic aneurysms, specifically pseudoaneurysms (PAs) of the superior mesenteric artery (SMA), are infrequently documented, with few cases reported since their initial description in 1885.
  • This study focuses on two rare cases of SMA pseudoaneurysms (PAs) directly associated with infective endocarditis.

Observation:

  • A 59-year-old male with a history of intravenous drug use presented with abdominal pain, diagnosed with Streptococcus viridans endocarditis and an SMA PA.
  • A 35-year-old female presented with abdominal pain and Streptococcos gordonii endocarditis complicated by an SMA PA, initially managed conservatively.

Findings:

  • The first patient underwent successful open surgery involving ligation of the SMA proximal and distal to the PA, with a favorable recovery.
  • The second patient experienced clinical deterioration, necessitating open ligation of the SMA, bypass surgery, and resection of ischemic small bowel, but ultimately succumbed to recurrent ischemia.

Implications:

  • Superior mesenteric artery (SMA) pseudoaneurysms (PAs) secondary to infective endocarditis, though rare, pose a significant threat of rupture, morbidity, and mortality.
  • Timely surgical management of SMA PAs is critical; delayed intervention is associated with increased risk and poorer outcomes.