2023-11-05 01:35:04
The 59-year-old Mr. Cai often suffers from mouth ulcers, sometimes caused by biting the skin while eating, and sometimes caused by unexplained small ulcers or blood blisters. A few days ago, he developed oral ulcers again. He didn’t take it seriously at first, but soon he went to a hospital near his home because of a fever. He was hospitalized for two days with suspected pneumonia. After he was discharged, he still had fever intermittently. A while ago, he was sent to hospital because of sudden chest tightness and difficulty breathing. Go to the hospital for emergency treatment.
The examination found that Mr. Cai’s blood oxygen concentration was only 92% (normal is 95%), and his bilateral lung infiltration and inflammation index were extremely high. He was intubated and admitted to the intensive care unit for treatment. The medical team was worried that the serious infection was related to heart disease, so they called the cardiovascular department for an ultrasound examination. The results revealed that his mitral valve had severe regurgitation and multiple vegetations. The final diagnosis was that it was caused by the oral bacteria “Streptococcus sanguinis”. Infective endocarditis complicated by mitral regurgitation.
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Severe mitral regurgitation may be life-threatening
The mitral valve, also known as the mitral valve, is a valve located between the left atrium and left ventricle that controls blood flow. The left ventricle is the most important structure in the heart for outputting blood. When the left ventricle contracts, the mitral valve closes, allowing the left ventricle to infuse blood to the body’s large blood vessels and supply tissues throughout the body. Reverse flow means that when the left ventricle contracts, the mitral valve cannot Completely closed, some blood will flow backwards into the left atrium. Dr. Luo Chongyou from the Department of Cardiovascular Surgery at Taipei Tzu Chi Hospital explained that blood can feed all organs, but mitral regurgitation can cause a significant decrease in cardiac output, which can lead to severe cardiogenic shock and multiple organ failure. Reduced blood can cause hoarding. Causes severe pulmonary edema in the lungs, which is life-threatening.
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Minimally invasive surgery is the main treatment, and special conditions are treated with traditional surgery.
If it is just simple mitral regurgitation, it can be treated with minimally invasive surgery. However, Mr. Cai’s condition is not simple, because his mitral valve not only has reflux, but also has a large damage of about 1 cm, and there are many surrounding areas. The growth of bacterial infections makes antibiotic treatment of limited effectiveness. Considering the patient’s condition, minimally invasive surgery would be too time-consuming and life-threatening, so the medical team decided to use traditional surgery.
First, a 20-centimeter incision is made in the center of the patient’s chest. After sawing through the sternum, the heart is paralyzed and stopped. The mitral valve is found and removed and surrounding vegetations are removed. Finally, a new artificial valve is implanted and the left atrium is sutured. , suture the wound after the heart restarts. Two days after the operation, the patient’s pulmonary edema improved significantly, and he was discharged from the hospital after continued antibiotic treatment for six weeks.
Infectious endocarditis should pay attention to oral health care
Foreign studies have pointed out that the annual incidence of infective endocarditis is about 3 to 10 per 100,000 people, and 20% of them are caused by viridans streptococci in the oral cavity. The disease enters through the mouth. Luo Chongyou reminded that any bacteria in the blood have the risk of infecting the heart. Although the human immune system will try to kill the bacteria at the beginning of the infection, if the number of bacteria is too large, it will be difficult to cure the proliferation of vegetations.
Therefore, you must pay attention to oral health, brush your teeth frequently, and use mouthwash to maintain oral health. If you have ulcers or inflammation, seek medical treatment. If you have a heart disease or if you need oral treatment before or after surgery, you should also inform your doctor to evaluate whether you need to take preventive medications. Antibiotics to prevent germs from invading the blood and causing infection during treatment.
(Picture source: Dreamstime/Dianjiang Image)
Further reading:
·His repeated fevers after tooth extraction turned out to be fatal endocarditis!Doctors reveal “9 types of people are extremely dangerous”: 1 thing to do before treating teeth
·Using mouthwash every day is wrong!Doctors reveal “4 shocking consequences”: they may also cause changes in taste
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