Endocarditis: The Precipitation of a Mitral Insufficiency
The group A (beta-hemolytic) streptococcus is the most common cause of throat infection and impetigo. In the majority of the streptococcus infections, there are no major consequences, but in genetic predisposed patients, immune events (the production of antibodies against the person’s own tissues) may occur, including fever and multiple painful joints in acute events, the rheumatic fever. The most worrisome sequel is carditis. In theory, any valve can be affected; however, those affecting the left heart (aortic and mitral valves) are more common, and valve regurgitation (or insufficiency) is the most common presentation of this pathology. In some cases surgical valve repair and valve replacement may be necessary. In addition to hemodynamic conditions, the person becomes predisposed to other diseases (because of the distortion of the structures of the valves), such as infectious endocarditis, and thus to more potentially serious health risks. For these reasons the recognition of rheumatic fever, a common condition in undeveloped countries, has an extreme importance for clinical practice. As there is a broad spectrum of valve injury, the recognition of surgical indication, as well as adequate techniques, may be the differential for the good treatment of the patient. This way, quality of life and life expectancy are improved, in the same way as potential lethal complications such as endocarditis reduce.
- 1.ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with Valvular heart disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. 2006;114(5):450–527.Google Scholar
- 2.Braunwald E, Bonow R. Braunwald’s heart disease. 1st ed. Philadelphia: Saunders; 2012.Google Scholar
- 3.Cohn L. Cardiac surgery in the adult. 1st ed. New York: McGraw-Hill Medical; 2008. p. 1072.Google Scholar