Isolated pulmonic valve endocarditis is an uncommon clinical entity and is usually associated with intravenous drug abuse. We describe a case of isolated pulmonary valve endocarditis in a young woman with no apparent precipitating factors other than a history of recent normal delivery. During the clinical course she suffered a pulmonary embolism which could be managed conservatively and she was discharged after a 4-week course of antibiotic therapy. The literature on the isolated pulmonary valve endocarditis is reviewed.
Low BMI and normal WC were associated with a worse short-term outcome in patients with acute MI. Neither BMI nor WC independently predicted cardiac events or death after acute MI.
We report a 42-year-old lady on combined oral contraceptive pills with deep venous thrombosis and mild pulmonary embolism, who developed shock, while being treated with heparin. On auscultation, there was an unexpected loud, superficial, squeaky, triphasic friction rub over the left lower parasternal area. Simultaneous echocardiogram revealed a large serpiginous, freely floating mass in right atrium, prolapsing freely to right ventricular inlet across the tricuspid valve. The endocardial friction rub persisted for about 24 h as long as the thrombus was intracardiac and disappeared when the thrombus disappeared from right heart, occluding the proximal left pulmonary artery. She died due to shock awaiting surgery. We highlight that such a rub in a patient with deep venous thrombosis, though rare, may be an important clue to impending pulmonary embolism.
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