A myocardial abscess is a potentially fatal endocardial condition, and early detection and treatment are critical for patient survival. A myocardial abscess is typically a consequence of endocarditis affecting native or artificial valves.
On the other hand, a myocardial abscess can occur in various conditions, including infective endocarditis, suppurative pericarditis, trauma, HIV, parasite infections, and an infected transplanted heart.
Epidemiology
The most prevalent pathogen is Staphylococcus aureus. The mitral valve is most typically affected in individuals with native valves and cardiac tissue. The incidence of infective endocarditis is believed to be around 15%.
In the case of prosthetic tissue or valves, the peri-annular infection spreads to the myocardium and results in paravalvular abscesses due to valve dehiscence.
Anatomy
Pathophysiology
Current or previous infective endocarditis is the most common cause of a myocardial abscess. The aortic valve is the most affected region, followed by the mitral valves, papillary muscles and ventricular septa. The most prevalent causal agent, S. aureus, is detected in up to one-third of the cases and has an even greater prevalence in patients with prosthetic valves.
Bacteremia is significant, even though abscesses caused by bacteremia are rarely significant enough to cause mortality and are usually described as an incidental postmortem observation in most literature. Prior MI is considered a precipitating risk factor for myocardial abscess formation in individuals with bacteremia.
Such circumstance is plausible in a patient with a history of infection enduring an acute coronary syndrome or developing the infection shortly after a MI. It is also believed that, in addition to the inflammatory state and diminished perfusion with lack of blood flow, the existence of necrosis of muscle fibers post-MI enhances myocardial vulnerability to this consequence.
Etiology
Myocardial abscesses are often assumed to be caused by the severity of a existing cardiac infection, as in the case of infective endocarditis.
Other causes of myocardial abscess are thought to be bacteremia (transient or persistent) without a recognized cardiac source, as well as vulnerable heart tissue shortly after myocardial infarction, or prosthetic valve dysfunction, generally in the presence of bacteremia.
Severe burns, trauma, piercing wounds, pseudoaneurysm, infected transplanted hearts, parasite infections, infected sternal incision sites, or HIV are less prevalent risk factors.
Genetics
Prognostic Factors
Patients recover quickly if the diagnosis is detected early and treatment begins immediately. The prognosis is typically not favorable without surgical intervention.
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
Future Trends
Media Gallary
References
https://www.ncbi.nlm.nih.gov/books/NBK459132/
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A myocardial abscess is a potentially fatal endocardial condition, and early detection and treatment are critical for patient survival. A myocardial abscess is typically a consequence of endocarditis affecting native or artificial valves.
On the other hand, a myocardial abscess can occur in various conditions, including infective endocarditis, suppurative pericarditis, trauma, HIV, parasite infections, and an infected transplanted heart.
The most prevalent pathogen is Staphylococcus aureus. The mitral valve is most typically affected in individuals with native valves and cardiac tissue. The incidence of infective endocarditis is believed to be around 15%.
In the case of prosthetic tissue or valves, the peri-annular infection spreads to the myocardium and results in paravalvular abscesses due to valve dehiscence.
Current or previous infective endocarditis is the most common cause of a myocardial abscess. The aortic valve is the most affected region, followed by the mitral valves, papillary muscles and ventricular septa. The most prevalent causal agent, S. aureus, is detected in up to one-third of the cases and has an even greater prevalence in patients with prosthetic valves.
Bacteremia is significant, even though abscesses caused by bacteremia are rarely significant enough to cause mortality and are usually described as an incidental postmortem observation in most literature. Prior MI is considered a precipitating risk factor for myocardial abscess formation in individuals with bacteremia.
Such circumstance is plausible in a patient with a history of infection enduring an acute coronary syndrome or developing the infection shortly after a MI. It is also believed that, in addition to the inflammatory state and diminished perfusion with lack of blood flow, the existence of necrosis of muscle fibers post-MI enhances myocardial vulnerability to this consequence.
Myocardial abscesses are often assumed to be caused by the severity of a existing cardiac infection, as in the case of infective endocarditis.
Other causes of myocardial abscess are thought to be bacteremia (transient or persistent) without a recognized cardiac source, as well as vulnerable heart tissue shortly after myocardial infarction, or prosthetic valve dysfunction, generally in the presence of bacteremia.
Severe burns, trauma, piercing wounds, pseudoaneurysm, infected transplanted hearts, parasite infections, infected sternal incision sites, or HIV are less prevalent risk factors.
Patients recover quickly if the diagnosis is detected early and treatment begins immediately. The prognosis is typically not favorable without surgical intervention.
https://www.ncbi.nlm.nih.gov/books/NBK459132/
medtigo
Myocardial abscess
Updated :
October 8, 2022
A myocardial abscess is a potentially fatal endocardial condition, and early detection and treatment are critical for patient survival. A myocardial abscess is typically a consequence of endocarditis affecting native or artificial valves.
On the other hand, a myocardial abscess can occur in various conditions, including infective endocarditis, suppurative pericarditis, trauma, HIV, parasite infections, and an infected transplanted heart.
The most prevalent pathogen is Staphylococcus aureus. The mitral valve is most typically affected in individuals with native valves and cardiac tissue. The incidence of infective endocarditis is believed to be around 15%.
In the case of prosthetic tissue or valves, the peri-annular infection spreads to the myocardium and results in paravalvular abscesses due to valve dehiscence.
Current or previous infective endocarditis is the most common cause of a myocardial abscess. The aortic valve is the most affected region, followed by the mitral valves, papillary muscles and ventricular septa. The most prevalent causal agent, S. aureus, is detected in up to one-third of the cases and has an even greater prevalence in patients with prosthetic valves.
Bacteremia is significant, even though abscesses caused by bacteremia are rarely significant enough to cause mortality and are usually described as an incidental postmortem observation in most literature. Prior MI is considered a precipitating risk factor for myocardial abscess formation in individuals with bacteremia.
Such circumstance is plausible in a patient with a history of infection enduring an acute coronary syndrome or developing the infection shortly after a MI. It is also believed that, in addition to the inflammatory state and diminished perfusion with lack of blood flow, the existence of necrosis of muscle fibers post-MI enhances myocardial vulnerability to this consequence.
Myocardial abscesses are often assumed to be caused by the severity of a existing cardiac infection, as in the case of infective endocarditis.
Other causes of myocardial abscess are thought to be bacteremia (transient or persistent) without a recognized cardiac source, as well as vulnerable heart tissue shortly after myocardial infarction, or prosthetic valve dysfunction, generally in the presence of bacteremia.
Severe burns, trauma, piercing wounds, pseudoaneurysm, infected transplanted hearts, parasite infections, infected sternal incision sites, or HIV are less prevalent risk factors.
Patients recover quickly if the diagnosis is detected early and treatment begins immediately. The prognosis is typically not favorable without surgical intervention.
https://www.ncbi.nlm.nih.gov/books/NBK459132/
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