title: Ventricular tachycardia: ominous sign of devastating prosthetic aortic valve dehiscence.
abstract: Prosthetic valve endocarditis (PVE) is the most feared complication after valve implantation. It usually results in substantial morbidity and mortality in the postoperative period. An adverse effect on the annulus can cause conduction disturbances in the atrioventricular (AV) node, resulting in a high-degree AV block. This study describes a case of PVE that predominantly presented with sustained monomorphic ventricular tachycardia, which indicated a severe clinical course of PVE caused by a significant displacement of the aortic valve prosthesis. In our opinion, a very pronounced flap valve motion of the dehisced valve probably caused, in the critical moment, coronary artery blood flow limitation by means of coronary microembolization, which produced temporary ischemia and provoked sustained ventricular tachycardia. Furthermore, disturbances of rhythm such as ventricular tachycardia in the setting of endocarditis indicate a high-risk condition and should mandate fast and thorough noninvasive diagnostic procedures to obtain correct diagnosis even in the case of mild, slowly progressing disease.
authors.affiliation: Ms. Mario Sicaja ., Department of Cardiology,, Clinical Hospital Dubrava,, Av Gojka Suska6 I.kat Zagreb 1000, Croatia, T: +385 1 290 2420, F: +385 1 286 3652, mario.sicaja@gmail.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Sicaja
authors.forename: Davor
authors.initials: D
authors.lastname: Baric
authors.forename: Daniel
authors.initials: D
authors.lastname: Unic
authors.forename: Srecko
authors.initials: S
authors.lastname: Marusic
authors.forename: Josip
authors.initials: J
authors.lastname: Vincelj
authors.affiliation: Ms. Mario Sicaja ., Department of Cardiology,, Clinical Hospital Dubrava,, Av Gojka Suska6 I.kat Zagreb 1000, Croatia, T: +385 1 290 2420, F: +385 1 286 3652, mario.sicaja@gmail.com.
authors.forename: Maria Nicole
authors.initials: MN
authors.lastname: Sicaja
authors.forename: Boris
authors.initials: B
authors.lastname: Starcevic
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology*