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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Restrictive subpulmonary ventricular septal defect with jet from the left to the right ventricular outflow tract &#40;arrow&#41; and infundibular pulmonary stenosis &#40;arrowhead&#41; with turbulent flow&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The authors present the case of a 39-year-old man with a history of unspecified congenital heart disease&#44; who was asymptomatic and had never undergone any intervention or cardiological follow-up&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">He was admitted for insidious weight loss&#44; fatigue and fever&#46; He presented a IV&#47;VI systolic murmur over the precordium&#44; hepatosplenomegaly and lower limb edema&#46; <span class="elsevierStyleItalic">Streptococcus viridans</span> was isolated from blood cultures and multiple foci of pulmonary and splenic emboli were identified&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Transthoracic and transesophageal echocardiography revealed a restrictive subpulmonary ventricular septal defect &#40;VSD&#41; and infundibular pulmonary stenosis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a> and Video 1&#41;&#44; with multiple vegetations related to the VSD involving the right coronary cusp of the aortic valve and protruding into the right ventricular outflow tract &#40;RVOT&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a> and Videos 2 and 3&#41;&#46; Vegetations were also observed adhering to the pulmonary valve and the pulmonary artery wall&#44; probably due to jet lesion &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a> and Video 4&#41;&#46; A diagnosis of infectious endocarditis was made and the patient underwent surgery for removal of the vegetations &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>&#41;&#44; VSD closure&#44; enlargement of the RVOT and pulmonary valvuloplasty without use of prosthetic material&#46; His postoperative course was good&#44; with no significant residual lesions&#44; and there were no signs of heart failure or recurrence of endocarditis after two years of follow-up&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">This case is an example of congenital heart disease with multiple defects with an indolent course that was manifested by aggressive infectious endocarditis involving the left and right valves and with high embolic risk&#46; It also highlights the success of surgical intervention to simultaneously remove the infected material and repair the congenital defects&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association &#40;Declaration of Helsinki&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Image in Cardiology
Adult congenital heart disease: A substrate for infective endocarditis
Cardiopatia congénita do adulto, substrato para endocardite infeciosa
Mariana Faustinoa,
Corresponding author
marianafaustino85@gmail.com

Corresponding author.
, António Freitasa, Ana Oliveira Soaresa, José Fragatab, Victor M. Gila, Carlos Moraisa
a Serviço de Cardiologia, Hospital Fernando Fonseca, Amadora, Portugal
b Serviço de Cirurgia Cardiotorácica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
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        "titulo" => "Cardiopatia cong&#233;nita do adulto&#44; substrato para endocardite infeciosa"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Restrictive subpulmonary ventricular septal defect with jet from the left to the right ventricular outflow tract &#40;arrow&#41; and infundibular pulmonary stenosis &#40;arrowhead&#41; with turbulent flow&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The authors present the case of a 39-year-old man with a history of unspecified congenital heart disease&#44; who was asymptomatic and had never undergone any intervention or cardiological follow-up&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">He was admitted for insidious weight loss&#44; fatigue and fever&#46; He presented a IV&#47;VI systolic murmur over the precordium&#44; hepatosplenomegaly and lower limb edema&#46; <span class="elsevierStyleItalic">Streptococcus viridans</span> was isolated from blood cultures and multiple foci of pulmonary and splenic emboli were identified&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Transthoracic and transesophageal echocardiography revealed a restrictive subpulmonary ventricular septal defect &#40;VSD&#41; and infundibular pulmonary stenosis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a> and Video 1&#41;&#44; with multiple vegetations related to the VSD involving the right coronary cusp of the aortic valve and protruding into the right ventricular outflow tract &#40;RVOT&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a> and Videos 2 and 3&#41;&#46; Vegetations were also observed adhering to the pulmonary valve and the pulmonary artery wall&#44; probably due to jet lesion &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a> and Video 4&#41;&#46; A diagnosis of infectious endocarditis was made and the patient underwent surgery for removal of the vegetations &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>&#41;&#44; VSD closure&#44; enlargement of the RVOT and pulmonary valvuloplasty without use of prosthetic material&#46; His postoperative course was good&#44; with no significant residual lesions&#44; and there were no signs of heart failure or recurrence of endocarditis after two years of follow-up&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">This case is an example of congenital heart disease with multiple defects with an indolent course that was manifested by aggressive infectious endocarditis involving the left and right valves and with high embolic risk&#46; It also highlights the success of surgical intervention to simultaneously remove the infected material and repair the congenital defects&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association &#40;Declaration of Helsinki&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Faustino M&#44; Freitas A&#44; Oliveira Soares A&#44; Fragata J&#44; Gil VM&#44; Morais C&#46; Cardiopatia cong&#233;nita do adulto&#44; substrato para endocardite infeciosa&#46; Rev Port Cardiol&#46; 2015&#59;34&#58;145&#8211;146&#46;</p>"
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Article information
ISSN: 21742049
Original language: English
DOI:10.1016/j.repce.2014.08.010
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