Keywords: subacute infective endocarditis
Clinical manifestations of subacute infective endocarditis: Most cases slow onset of fever, weakness, fatigue, few acute onset, chills, fever, or embolic phenomena, some patients before the onset of oral surgery, respiratory infections, a history of miscarriage or childbirth.
Systemic infection fever is the most common, and often has unexplained persistent fever for more than a week, irregular fever, more than 37.5 ℃ -39 ℃ for intermittent fever or remittent fever, accompanied by fatigue, night sweats, conducted anemia, splenomegaly, late clubbing of the fingers.
Second, the cardiac performance inherent in the signs of a heart attack, due to the growth of vegetation or off, changing valves, tendons destruction, noise, or a new murmur. The absence of noise can not be other than endocarditis exist, with advanced heart failure can occur. When the infection spread to the atrioventricular bundle or ventricular septal cause atrioventricular block and bundle branch block, rare arrhythmia may have premature beats or atrial fibrillation.
Embolic phenomena and disease losses
(A) of the skin and mucous membrane lesions caused by the toxin infection and bleeding capillaries make it brittle increase or microembolization. In the limbs to the skin and eyes alkaline conjunctival, oral mucosal petechiae batches, there may be slightly higher than the surface of purple or red Albright (Osler) nodules in the fingers, toes distal palm, also available in the palm of your hand or foot a small nodular bleeding the point (Janewey nodules), no tenderness.
(B) cerebrovascular disease losses can have the following performance:
① meningoencephalitis like tubercular meningitis, cerebrospinal fluid pressure, protein and increased white blood cell count, normal chloride or sugar quantitative. (2) cerebral hemorrhage persistent headache or meningeal irritation caused by bacterial aneurysm rupture. ③ cerebral embolism patients with fever, sudden onset of paralysis or blindness. (4) central retinal embolism can cause sudden blindness.
(C) renal embolism is the most common, accounting for about 1/2 of the cases, gross or microscopic hematuria, severe renal insufficiency often due to bacterial infection, the antigen – antibody complex deposition in the renal vessels ball, causing kidney glomerulonephritis results.
(D) pulmonary embolism is common in congenital heart disease and infective endocarditis cases, more than in the right ventricle or pulmonary artery intimal surface vegetation, the incidence of acute chest pain, dyspnea, hemoptysis, cyanosis or shock. Infarct size is small, no obvious symptoms.
Can also have coronary embolism, acute infarction, splenic embolization left upper abdominal pain or left hypochondrium pain, fever and local friction rub. Mesenteric artery embolization, manifested as acute abdomen, blood in the stool. Can embolism limbs pale chills limb arterial embolism, arterial pulse weakened or disappeared, limb ischemia and pain.