PDF(Pubmed)
Abstract：
Infective endocarditis (IE) can cause life-threatening intracerebral hemorrhage via the transformation of an embolic ischemic stroke. Navigating anticoagulant therapy for IE patients is challenging due to this risk. Hospitalized patients often receive anticoagulation to minimize venous thromboembolism (VTE). Those at higher VTE risk may require full anticoagulation, particularly if there is an initial suspicion of a blood clot. A timely IE diagnosis is crucial but is often delayed during inpatient stays, with the patient potentially already on anticoagulants for other conditions. Our case discusses a hemorrhagic stroke in a patient with IE while receiving therapeutic enoxaparin. Clinical signs and symptoms, echocardiographic findings, laboratory workup and microbiological data, and possibly other imaging techniques such as cerebral magnetic resonance imaging (MRI) need to be employed in a timely manner in determining endocarditis as a cause of stroke.
摘要：
感染性心内膜炎（IE）可通过栓塞性缺血性中风的转化引起危及生命的脑出血。由于这种风险，IE患者的抗凝治疗具有挑战性。住院患者通常接受抗凝治疗以最大程度地减少静脉血栓栓塞（VTE）。VTE风险较高的患者可能需要全面抗凝治疗，特别是如果有血块的初步怀疑。及时的IE诊断至关重要，但在住院期间通常会延迟，患者可能已经在其他条件下服用抗凝剂。我们的病例讨论了接受治疗性依诺肝素的IE患者的出血性中风。临床症状和体征,超声心动图检查结果,实验室检查和微生物数据，以及可能的其他成像技术，例如脑磁共振成像（MRI），需要及时使用来确定心内膜炎是中风的原因。
