RUPTURED AORTIC VALVE WITH MYCOTIC ANEURYSM DUE TO ACUTE BACTERIAL ENDOCARDITIS

PREMATURE MITRAL VALVE CLOSURE: A HEMODYNAMIC EXPLANATION FOR ABSENCE OF THE FIRST SOUND IN AORTIC INSUFFICIENCY

The phenomenon of premature mitral valve closure is described in three patients with severe aortic insufficiency and related to absence of the first heart sound.

The occurrence of premature mitral closure is favored by severe aortic regurgitation probably with increased impedance to left ventricular filling.

Available evidence suggests that this phenomenon usually occurs in the more rapidly developing forms of aortic incompetence (bacterial endocarditis, post surgical, and traumatic rupture of the valve), that it is uncommon, and that it often implies a grave prognosis.

It should be suspected when the apical first heart sound is absent in aortic incompetence.

Abscesses of the Valve Rings of the Heart, a Frequent but Not Well Recognized Complication of Acute Bacterial Endocarditis

Abscesses of the valve rings of the heart were encountered at autopsy in 86 per cent of patients with acute bacterial endocarditis who had received antibiotic therapy. The abscesses, which appeared to arise from mycotic aneurysms in the valve rings, represented in most instances the only persistent focus of acute inflammation. They may account in part for the unsatisfactory results in the treatment of acute bacterial endocarditis, and their frequent occurrence suggests a relationship to antibiotic therapy.