Streptococcus pneumoniae is a gram-positive, catalase-negative cocci that has remained an extremely important human bacterial pathogen since its

initial recognition in the late 1800s. The term pneumococcus gained widespread use by the late 1880s, when it was recognized as the most common cause of bacterial lobar pneumonia. Worldwide, S pneumoniae remains the most common cause of community-acquired pneumonia (CAP), bacterial meningitis, bacteremia, and otitis media. S pneumoniae infection is also an important cause of sinusitis, septic arthritis, osteomyelitis, peritonitis, and endocarditis and an infrequent cause of other less-common diseases.

http://emedicine.medscape.com/article/225811-overview
Streptococcus pneumoniae, or pneumococcus, is Gram-positive, alpha-hemolytic, aerotolerant anaerobic member of the genus Streptococcus. A significant human pathogenic bacterium, S. pneumoniae was recognized as a major cause of pneumonia in the late 19th century, and is the subject of many humoral immunity studies. Despite the name, the organism causes many types of pneumococcal infections other thanpneumonia, including acute sinusitis, otitis media, meningitis, bacteremia, sepsis, osteomyelitis,septic arthritis, endocarditis, peritonitis, pericarditis, cellulitis, and brain abscess.
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http://en.wikipedia.org/wiki/Streptococcus_pneumoniae

Pneumonia facts

Pneumonia is a lung infection that can be caused by different types of microorganisms, including bacteria, viruses, and fungi.

Symptoms of pneumonia include cough with sputum production, fever, and sharpchest pain on inspiration (breathing in).

Pneumonia is suspected when a doctor hears abnormal sounds in the chest, and the diagnosis is confirmed by a chest X-ray.

Bacteria causing pneumonia can be identified by sputum culture.

A pleural effusion is a fluid collection around the inflamed lung.

Bacterial and fungal (but not viral) pneumonia can be treated with antibiotics.

http://www.medicinenet.com/pneumonia/article.htm What Is Pneumonia?

Pneumonia (pronounced: noo-mow-nyuh) is an infection of the lungs. When someone has pneumonia, lung tissue can fill with pus and other fluid, which makes it difficult for oxygen in the lung's air sacs to reach the bloodstream. With pneumonia, a person may have difficulty breathing and have a cough and fever; occasionally, chest or abdominal pain and vomiting are symptoms, too. Pneumonia is commonly caused by viruses, such as the influenza virus (flu) and adenovirus. Other viruses, such as respiratory syncytial virus (RSV), are common causes of pneumonia in young children and infants. Bacteria such as Streptococcus pneumoniae can cause pneumonia, too. People with bacterial pneumonia are usually sicker than those with viral pneumonia, but can be effectively treated with antibiotic medications.

http://kidshealth.org/teen/infections/bacterial_viral/pneumonia.html

Ischemic Cardiomyopathy
Ischemic cardiomyopathy is a term that doctors use to describe patients who have congestive heart failure due tocoronary artery disease. "Ischemic" means that an organ (such as the heart) is not getting enough blood and oxygen. "Cardio" means heart and "myopathy" means muscle-related disease.

Causes
Ischemic cardiomyopathy results when the arteries that bring blood and oxygen to the heart are blocked. There may be a build-up of cholesterol and other substances, called plaque, in the arteries that bring oxygen to heart muscle tissue. Ischemic cardiomyopathy is a common cause of congestive heart failure. Patients with this condition may at one time have had a heart attack, angina, or unstable angina. A few patients may not have noticed any previous symptoms.

Ischemic cardiomyopathy is the most common type of cardiomyopathy in the United States. It affects approximately 1 out of 100 people, most often middle-aged to elderly men. Risks for this condition include:

Personal or family history of heart attack, angina, unstable angina, atherosclerosis, or other coronary artery diseases High blood pressure Smoking Diabetes High fat diet High cholesterol Obesity
Back to TopSymptoms

o o o o

Chest pain Under the chest bone May move (radiate) to the neck, jaw, back, shoulder, arm May feel tight, pressure, crushing, squeezing May or may not be relieved by rest or nitroglycerin Sensation of feeling the heart beat (palpitations) Irregular or rapid pulse Shortness of breath, especially with activity Shortness of breath that occurs after lying down for a while Cough Fatigue, weakness, faintness Decreased alertness or concentration Decreased urine output Excessive urination at night Overall swelling Breathing difficulty when lying down
Back to TopExams

and Tests

The physical examination may be normal, or it may reveal signs of fluid buildup (leg swelling, enlarged liver, "crackles" in the lungs, extra heart sounds, or an elevated pressure in the neck vein). There may be other signs of heart failure. The diagnosis of this condition is usually made only if a test shows that the pumping function of the heart is too low. This is called a decreased ejection fraction. A normal ejection fraction is around 55 - 65%. Most patients with this disorder have ejection fractions much less than this. Tests used to measure ejection fraction include:

Echocardiogram Ventriculogram performed during a cardiac catheterization

Gated SPECT MRI of chest ECG Biopsy of the heart is needed in rare cases to rule out other disorders. Lab tests that may be used to rule out other disorders and to assess the condition of the heart include:

CBC Coronary risk profile Blood chemistries Cardiac biochemical markers (CK-MB, troponin)
Back to TopTreatment

The goal of treatment is to relieve symptoms and treat the cause of the condition. If symptoms are severe, you may need to stay in the hospital. Several types of medications have been found to help patients live longer with this disorder. They include ACEinhibitors (captopril, lisinopril), beta-blockers (metoprolol, carvedilol), and diuretics such as furosemide (Lasix), spironolactone, and eplerenone. A cardiac catheterization will be done to see if you can have bypass surgery or angioplasty ("balloon procedure"). These treatments can improve blood flow to the damaged or weakened heart muscle. A number of studies have shown that heart failure symptoms can be improved with a special type of pacemaker. It paces both the right and left sides of heart. This is referred to as biventricular pacing or cardiac resynchronization therapy. Ask your provider if this therapy is right for you. A heart transplant may be recommended for patients who have failed all the standard treatments and still have very severe symptoms. Recently, implantable, artificial heart pumps have been developed. At this point, very, very few patients will be able to undergo either of these advanced treatments. If you smoke or drink alcohol excessively, stop doing so, because these habits increase the stress on the heart.
Back to TopOutlook

(Prognosis)

This is a very serious disorder. Patients with this condition, in general, do not have a normal lifespan. For some, the prognosis is just as bad as for many forms of cancer. Thus, it is very important to discuss your particular situation with your doctor to ensure that you can improve it as much as possible.
Back to TopPossible

Complications

Arrhythmias, including lethal arrhythmias Cardiogenic shock

Back to TopWhen

to Contact a Medical Professional

Go to the emergency room or call 911 if you have symptoms that may be ischemic cardiomyopathy, or if chest pain is present and not relieved by rest or nitroglycerin.
Back to TopPrevention

The best way to prevent ischemic cardiomyopathy is to avoid getting heart disease. Stop smoking, eat a healthy diet, maintain a healthy weight, exercise as much as possible, avoid excessive drinking, and see your doctor to control blood pressure, cholesterol, and diabetes.

http://health.nytimes.com/health/guides/disease/ischemic-cardiomyopathy/overview.html Ventricular dysfunction in heart failure

The major role of the ventricles in pumping blood to the lungs and body means that even a slight decrease in ventricular efficiency can have a significant impact on heart function. If the left ventricle encounters either absolute or relative functional insufficiency (called left ventricular heart failure, or left-sided heart failure), a series of compensatory reactions are initiated that may temporarily provide a return to sufficient ventricular function. One mechanism of compensation associated with left ventricular failure is left ventricular enlargement, which can increase the volume of blood that is ejected from the ventricle, temporarily ... (100 of 23742 words)