Culture-negative suppurative endocarditis causing severe mitral valve obstruction: complementary use of transesophageal and transthoracic echocardiography.
Infective endocarditis causes a myriad number of serious complications. Mitral valve obstruction is a rare complication. We report a 48-year-old Asian female who presented with two-week duration of fever and rapidly developed acute pulmonary edema and cardiogenic shock. Sequential transthoracic and transesophageal echocardiography revealed a rapidly growing vegetation on the anterior mitral leaflet with severe stenosis of the valve. All the blood cultures were negative. The patient underwent a successful mitral valve replacement. A review of 21 previously reported cases of mitral valve obstruction from endocarditis demonstrates the poor prognosis of this entity and supports early surgery.
Roychoudhury
Debasish
D
Department of Medicine, The New York Hospital Medical Center of Queens, Flushing, NY 11355, USA. dxroycho@nyp.org
Chaithiraphan
Vithaya
V
Stathopoulos
Ioannis A
IA
Fergus
Icilma
I
Tortolani
Anthony
A
Murkis
Marina A
MA
Messineo
Frank
F
D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery