Document Detail

Transesophageal echocardiographic demonstration of resolution of mitral vegetations after warfarin in a patient with the primary antiphospholipid syndrome.
MedLine Citation:
PMID:  7640017     Owner:  NLM     Status:  MEDLINE    
A 16-year-old girl with multiple cerebral infarcts was reported to have a normal transthoracic echocardiogram, but transesophageal echocardiography revealed vegetations on the atrial surfaces of both mitral leaflets at their line of closure. Blood cultures were negative, and prolonged treatment with intravenous antibiotics produced no echocardiographic improvement in the appearance of the vegetations. A diagnosis of primary antiphospholipid syndrome was made subsequently, although test results for this condition had initially been normal. Serial transesophageal echocardiograms showed complete resolution of the vegetations but some persistent thickening of the mitral leaflets, after warfarin therapy for 9 months. We suggest that in patients with culture-negative endocardial vegetations, specific tests should be performed for the primary antiphospholipid syndrome and a therapeutic trial of warfarin should be undertaken before contemplating heart surgery.
R A Skyrme-Jones; C A Wardrop; C M Wiles; A G Fraser
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  8     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:    1995 May-Jun
Date Detail:
Created Date:  1995-09-21     Completed Date:  1995-09-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  251-6     Citation Subset:  IM    
Department of Cardiology, University of Wales College of Medicine, Heath Park, UK.
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MeSH Terms
Antiphospholipid Syndrome / complications,  drug therapy,  ultrasonography*
Cerebral Infarction / complications
Echocardiography, Transesophageal*
Heart Valve Diseases / drug therapy,  etiology,  ultrasonography*
Mitral Valve / ultrasonography*
Warfarin / therapeutic use*
Reg. No./Substance:

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