Clinical Case Database / Category: Clinical Care
Non-specific symptoms in a patient with valvular heart disease
Publication details
Richard Bond BMedSci (Hons) MBBS (Hons) MRCP, Mark Dayer PhD MRCP
Foundation Years Journal, volume 3, issue 2, p.36 (123Doc Education, London, March 2009)
Abstract
A 46-year-old man presented to our medical assessment unit with a 3-week history of general malaise, muscle aches, night sweats, decreased appetite and a sore throat. He had been lost to follow-up at his local cardiology department with a diagnosis of aortic regurgitation (severity unknown). He had no other past medical history and was on no regular medication. Of note, his son had been diagnosed with a bicuspid aortic valve.
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Authors
Richard Bond BMedSci (Hons) MBBS (Hons) MRCP
Cardiology ST3
Musgrove Park Hospital
Taunton
Somerset
Mark Dayer PhD MRCP
Consultant Cardiologist
Musgrove Park Hospital
Taunton
Somerset
References
1. Cripe L, Andelfinger G, Martin LJ, et al. Bicuspid aortic valve is heritable. J Am Coll Cardiol, 7 July 2004, 44(1):138–143.
2. Hutchins GM, Nazarian IH, Bulkley BH. Association of left dominant coronary arterial system with congenital bicuspid aortic valve. Am J Cardiol, 1978, 42:57–59.
3. Murphy ES, Rösch J, Rahimtoola SH. Frequency and significance of coronary arterial dominance in isolated aortic stenosis. Am J Cardiol, 1977, 39:505–509.
4. Bayne E. Aortic Valve, Bicuspid. http://emedicine.medscape.com/ article/893523-overview.
5. Beppu S, Suzuki S, Matsuda H, et al. Rapidity of progression of aortic stenosis in patients with congenital bicuspid aortic valves. Am J Cardiol, 1993, 71(4):322–327.
6. Mautner GC, Mautner SL, Cannon RD, et al. Clinical factors useful in predicting aortic valve structure in patients >40 years of age with isolated valvular aortic stenosis. Am J Cardiol, 1993, 73:194–198.
7. Janatuinen MJ, Vanttinen EA, Nikoskelainen J, Inberg MV. Surgical treatment of active native valve endocarditis. Scand J Thorac Cardiovasc Surg, 1990, 24(3):181–185.
8. Varstela E, Verkkala K, Pohjola-Sintonen S, Valtonen, V, Maamies T. Surgical treatment of infective aortic valve endocarditis. Scand J Thorac Cardiovasc Surg, 1991, 25:167–174.
9. Lamas CC, Eykyn SJ. Bicuspid aortic valve – A silent danger: analysis of 50
cases of infective endocarditis. Clin Infect Dis, 2000, 30:336–341.
10. Larson EW, Edwards. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol, 1984, 53:849–855.
11. Parai JL, Masters RG, Walley VM, Stinson WA, Veinot JP. Aortic medial changes associated with bicuspid aortic valve: myth or reality? Can J Cardiol, 1999, 15:1233–1238.
12. ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). JACC, 1998, 32:1486–1588.
13. Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med, 2001, 345:1318–1330.
14. Moreillon P, Que YA. Infective endocarditis. Lancet, 2004, 363:139–149.
15. Tornos P, Lung B, Permanver-Miralda G, Baron G, Delahaye F, Gohlke- Bärwolf C, et al. Infective endocarditis in Europe: lessons from the Euro heart survey. Heart, 2005, 91:571–575.
16. Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME, et al. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the committee on Rheumatic Fever, Endocarditis and Kawasaki disease, Council on Cardiovascular disease in the Young and the Councils on Clincal
Cardiology, Stroke and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation, 2005, 111:E393–E434.
17. Hoen B, Selton-Suty C, Lacassin F, Etienne J, Briançon S, Leport C, Canton P. Infective endocarditis in patients with negative blood cultures: analysis of 88 cases from a 1-year nationwide survey in France. Clin Infect Dis, 1995, 20:501–506.
18. Lamas CC, Eykyn SJ. Blood culture negative endocarditis: analysis of 63 cases presenting over 25 years. Heart, 2003, 89:258–262.
19. Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis, 2000, 30:633–638.
20. Elliott TSJ, Foweraker J, Gould FK, Perry JD, Sandoe JAT. Guidelines for the antibiotic treatment of endocarditis in adults: report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother, 2004, 54:971–981.
21. Olaison L, Pettersson G. Current best practices and guidelines. Indications for surgical intervention in infective endocarditis. Cardiol Clin, 2003, 21:235–251.
22. D'Udekum Y, David, TE, Feindel CM, Armstrong S, Sun Z. Long-term results of surgery for active infective endocarditis. Eur J Cardio-Thoracic Surgery, 1997, 11:46–52.
23. National Institute for Health and Clinical Excellence. Prophylaxis Against Infective Endocarditis 2008. (NICE clinical guideline no. 64.) Available at: http://www.nice.org.uk/CG064. Patient consent obtained.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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