MYOCARDIAL LESIONS IN SUBACUTE BACTERIAL ENDOCARDITIS

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Abstract
Data on 43 non-penicillin-treated and 9 penicillin-treated patients with subacute bacterial endocarditis were studied, particularly with reference to the microscopic appearance of the myocardium. Some type of myocardial lesion was found in all except the 1 case in which the endocarditis was confined to the right side of the heart. The most commonly encountered lesion was the miliary infarct. Other lesions included interstitial and perivascular vellular infiltrates or scars and emboli. Aschoff nodules were found in less than 10%. A foreign body granuloma was present in one of the penicillin-treated series. Aside from this, the individual lesions in the untreated and treated groups were indistinguishable. Myocardial damage is probably but one of the several factors operating to bring about myocardial failure in subacute bacterial endocarditis.