title: Prosthetic valve endocarditis presenting as loss of the metallic click sound.
abstract: Prosthetic valve endocarditis is a significant infection. It is often serious, and may result in a complicated course leading to valvular malfunction. We present the case of a 50-year-old male with an aortic Medtronic Hall valve, who presented with loss of his normal metallic click. A transthoracic echocardiogram confirmed the diagnosis of endocarditis and of an aortic-root abscess. Blood cultures were positive for nutritionally deficient Streptococcus. He underwent successful surgery and later was discharged. Patients with mechanical heart valves are often bothered by the metallic sound. It can interfere with their daily life. However, the loss of the click may indicate valvular dysfunction, dehiscence of the prosthesis, and/or tissue infection with abscess formation.
authors.affiliation: Yale University School of Medicine, Department of Medicine, The Hospital of Saint Raphael, New Haven, CT 06511, USA. asreih@srhs.org
authors.forename: Antoine G
authors.initials: AG
authors.lastname: Sreih
authors.forename: Rahul
authors.initials: R
authors.lastname: Mehta
mesh_terms: D004562:Electrocardiography; D004696:Endocarditis / Q000175:diagnosis* / Q000188:drug therapy; D006327:Heart Block / Q000175:diagnosis* / Q000628:therapy; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure