Cardiac tamponade during transesophageal echocardiography in a patient with infective endocarditis.
An 81-year-old man with a history of diabetes mellitus and end-stage renal disease was admitted because of infective endocarditis. During transesophageal echocardiography (TEE), pericardial effusion rapidly increased and led to cardiac tamponade. Despite intensive therapy, the patient did not recover. Autopsy showed hemopericardium, ruptured sinus of Valsalva, and vegetation on the aortic valve. Our case suggests that cardiac tamponade due to the rupture of a sinus of Valsalva can occur in patients with aortic valve endocarditis complicated by perivalvular abscess. Therefore, we must be aware of this devastating complication and take preventive measures when performing TEE in such patients.
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan. miyamako@tenriyorozu-hp.or.jp.
Makoto
M
Miyake
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Chisato
C
Izumi
Department of Clinicopathology, Tenri Hospital, Tenri, Japan.
Kazuyo
K
Kuwano
Department of Pathology, Tenri Hospital, Tenri, Japan.
Gen
G
Honjo
Department of Clinicopathology, Tenri Hospital, Tenri, Japan.
Hayato
H
Matsutani
Department of Clinicopathology, Tenri Hospital, Tenri, Japan.
Sumiyo
S
Hashiwada
Department of Clinicopathology, Tenri Hospital, Tenri, Japan.
Shuichi
S
Takahashi
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Masataka
M
Nishiga
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Seiko
S
Nakajima
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Kazuya
K
Yamao
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Kouji
K
Hanazawa
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Jiro
J
Sakamoto
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Kazuyasu
K
Yoshitani
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Makoto
M
Motooka
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Kazuaki
K
Kaitani
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Toshiaki
T
Izumi
Department of Pathology, Tenri Hospital, Tenri, Japan.
Yoichiro
Y
Kobashi
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Yoshihisa
Y
Nakagawa
Cardiac tamponade; Infective endocarditis; Rupture of sinus of Valsalva; Transesophageal echocardiography