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Blurring of vision with malaise
We present the case of a 56-year-old female brought to the Emergency Department via routine ambulance transport with complaints of blurred vision and malaise. She was screened by ambulance crew using the facial arm speech time (FAST) tool and a basic top-to-toe assessment as per current routine. The examining practitioner performed a thorough assessment of the patient, revisiting the initial examination findings, and establishing new clinical features of visual field deficit and pan-systolic murmur. The likely diagnosis of septic emboli or stroke with infective endocarditis was identified through the power of rigorous hist...
Source: Journal of the Royal College of Physicians of Edinburgh - April 20, 2021 Category: General Medicine Authors: Mansoor Zafar Ratan Singh Randhawa Barnaby Peacock-Young Reem Eldebri Umesh Dashora Source Type: research

Neurological Complications in Patients with Infective Endocarditis: Insights from a Tertiary Centre
Conclusions: In this population, embolization to the CNS was common, more often presented as ischemic stroke, and was associated with longer hospitalization, although without significant differences in mortality. In patients with CNS embolization, those submitted to surgery had a good clinical evolution, while patients with septic shock and HIV infection had a worse outcome. These results should be interpreted with caution, taking into consideration that patients with more severe complications or more fragile were probably less often considered for surgery, resulting in selection bias.
Source: Arquivos Brasileiros de Cardiologia - April 16, 2021 Category: Cardiology Source Type: research

Managing Patients with Infectious Endocarditis and Neurological Complication — The Big Dilemma that Persists Until these Days
Conclusions: In this population, embolization to the CNS was common, more often presented as ischemic stroke, and was associated with longer hospitalization, although without significant differences in mortality. In patients with CNS embolization, those submitted to surgery had a good clinical evolution, while patients with septic shock and HIV infection had a worse outcome. These results should be interpreted with caution, taking into consideration that patients with more severe complications or more fragile were probably less often considered for surgery, resulting in selection bias.
Source: Arquivos Brasileiros de Cardiologia - April 16, 2021 Category: Cardiology Source Type: research

Antithrombotic Therapy for Stroke Patients with Cardiovascular Disease
Semin Neurol DOI: 10.1055/s-0041-1726331Prevention of ischemic stroke relies on the use of antithrombotic medications comprising antiplatelet agents and anticoagulation. Stroke risk is particularly high in patients with cardiovascular disease. This review will focus on the role of antithrombotic therapies in the context of different types of cardiovascular disease. We will discuss oral antiplatelet medications and both IV and parental anticoagulants. Different kinds of cardiovascular disease contribute to stroke via distinct pathophysiological mechanisms, and the optimal treatment for each varies accordingly. We will explo...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Gusdon, Aaron M. Farrokh, Salia Grotta, James C. Tags: Review Article Source Type: research

Cerebrovascular Complication and Valve Surgery in Infective Endocarditis
Semin Neurol DOI: 10.1055/s-0041-1726327Infective endocarditis (IE) with neurologic complications is common in patients with active IE. The most common and feared neurological complication of left-sided IE is cerebrovascular, from septic emboli causing ischemic stroke, intracranial hemorrhage (ICH), or an infectious intracranial aneurysm with or without rupture. In patients with cerebrovascular complications, valve replacement surgery is often delayed for concern of further neurological worsening. However, in circumstances when an indication for valve surgery to treat IE is present, the benefits of early surgical treatment...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Rice, Cory J. Kovi, Shivakrishna Wisco, Dolora R. Tags: Review Article Source Type: research

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