[Aortic valve insufficiency caused by nonpenetrating chest trauma difficult to distinguish from infective endocarditis with transesophageal echocardiography: a case report].
A 58-year-old man was involved in an automobile accident and suffered remittent fever, leukocytosis and high C-reactive protein level. He developed a diastolic murmur 2 months after the accident. Transesophageal echocardiography showed severe aortic regurgitation with a vegetation-like echo image attached to the right coronary cusp leaflet, suggesting infective endocarditis. Intensive medical treatment for 11 months did not improve the vegetation-like echo-image, so aortic valve replacement was performed. Disruption of the right coronary cusp leaflet was confirmed surgically. Prolapse had occurred as a result of disruption during diastole. The vegetation-like echo-image was considered to be the tip of this leaflet.
Hioki
J
J
First Department of Internal Medicine, Kinki University School of Medicine, Osaka.
Shibutani
T
T
Naito
T
T
Uehara
H
H
Sasaki
T
T
Hirano
Y
Y
Ikawa
H
H
Miyazaki
T
T
Ishikawa
K
K
Katori
R
R
D001022:Aortic Valve Insufficiency / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D013898:Thoracic Injuries / Q000150:complications*; D014949:Wounds, Nonpenetrating / Q000150:complications*