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[Clinical analysis of 14 infective endocarditis in patients with obstructive hypertrophic cardiomyopathy]

P Wang1, L Song2, X J Gao2

  • 1Cardiac Arrhythmia Center, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing 100037, China.

Zhonghua Nei Ke Za Zhi
|December 1, 2020
PubMed

Insights

Infective endocarditis (IE) in hypertrophic cardiomyopathy (HCM) patients is rare but serious. Early cardiac surgery is recommended for better outcomes in these complex cases.

Area of Science:

  • Cardiology
  • Infectious Diseases

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart condition.
  • Infective endocarditis (IE) is a serious infection of the heart lining.
  • The co-occurrence of IE and HCM presents unique clinical challenges.

Purpose of the Study:

  • To analyze the clinical characteristics of patients with both infective endocarditis and hypertrophic cardiomyopathy.
  • To understand the specific manifestations, pathogens, and outcomes in this patient cohort.

Main Methods:

  • Retrospective analysis of 14 patients diagnosed with both HCM and IE.
  • Data collected included clinical manifestations, blood cultures, echocardiography, treatment, and outcomes.
  • Comparison with general IE and HCM populations where applicable.

Main Results:

  • IE in HCM patients occurred in 0.19% of HCM cases.
  • Common symptoms included fever and heart murmur; heart failure and embolism were frequent complications.
  • Echocardiography revealed vegetation in all patients, often on the mitral valve, with severe left ventricular outflow obstruction.
  • Gram-positive cocci, primarily Streptococcus, were the main pathogens.

Conclusions:

  • IE is a rare but significant complication in HCM patients.
  • Septic embolization and valve lesions are prevalent, suggesting a poorer prognosis.
  • Early cardiac surgery intervention is crucial for improving survival rates in these patients.

Keywords:
BacterialCardiomyopathy, hypertrophicEndocarditisInfenctions

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