Document Detail

Left atrial appendage mimicking an intra-cardiac vegetation in preterm neonates.
MedLine Citation:
PMID:  17703106     Owner:  NLM     Status:  MEDLINE    
Infective endocarditis is emerging as a significant cause of morbidity in the neonatal intensive care with an incidence ranging from 0.07 to 4.3%. The rise in incidence may be explained by the increasing availability of echocardiography facilities in the neonatal unit. The diagnosis of infective endocarditis has major therapeutic implications as the neonate is treated with potentially toxic drugs and exposed to prolonged intravenous catheters. However, the consequences of a missed diagnosis of endocarditis in preterm neonates are unknown and may potentially lead to significant long-term cardiac complications. Onsite echocardiography in the neonatal unit by neonatologists may improve the speed of diagnosis in cases of endocarditis. However, lack of adequate training and experience in normal echocardiographic views may increase the false-positive rate. The posterior mitral valve leaflet is rarely affected due to the low velocity of blood passing through and because of the absence of prosthesis. We report 2 cases of the left atrial appendage rarely mimicking a posterior mitral valve leaflet vegetation, leading to an erroneous diagnosis of infective endocarditis. The features which distinguish the left atrial appendage from a posterior mitral valve leaflet vegetation are illustrated.
Afif F El-Khuffash; Eleanor J Molloy; Kevin Walsh
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-08-16
Journal Detail:
Title:  Neonatology     Volume:  93     ISSN:  1661-7819     ISO Abbreviation:  -     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-08     Completed Date:  2008-04-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  113-6     Citation Subset:  IM    
Copyright Information:
(c) 2007 S. Karger AG, Basel
Department of Neonatology, National Maternity Hospital, Dublin, Ireland.
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MeSH Terms
Atrial Appendage / ultrasonography*
Candidiasis / ultrasonography
Diagnosis, Differential
Endocarditis, Bacterial / ultrasonography*
Gram-Positive Bacterial Infections / ultrasonography
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / ultrasonography*
Pseudomonas Infections / ultrasonography

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