title: Culture-negative suppurative endocarditis causing severe mitral valve obstruction: complementary use of transesophageal and transthoracic echocardiography.
abstract: 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.
authors.affiliation: Department of Medicine, The New York Hospital Medical Center of Queens, Flushing, NY 11355, USA. dxroycho@nyp.org
authors.forename: Debasish
authors.initials: D
authors.lastname: Roychoudhury
authors.forename: Vithaya
authors.initials: V
authors.lastname: Chaithiraphan
authors.forename: Ioannis A
authors.initials: IA
authors.lastname: Stathopoulos
authors.forename: Icilma
authors.initials: I
authors.lastname: Fergus
authors.forename: Anthony
authors.initials: A
authors.lastname: Tortolani
authors.forename: Marina A
authors.initials: MA
authors.lastname: Murkis
authors.forename: Frank
authors.initials: F
authors.lastname: Messineo
mesh_terms: 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