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Staphylococcus Aureus Mitral Valve Endocarditis

Authors: Dr. Julia Grapsa, Dr. Grigorios Karamasis, Dr. Andreas Kalogeropoulos, Prof. Petros Nihoyannopoulos

Hammersmith Hospital
Imperial College NHS Trust

Contact : Julia Grapsa,
EACVI club 35 ambassador for Greece

On behalf of the EACVI club 35 for Greece


 

Description

  • ASB 20 yrs old woman
  • Weight loss and shortness of breath for the last 6 weeks
  • Pyrexial (39.6)
  • Past medical history: Nil
  • Social history: Smoker, Cocaine user

Clinical case information

ECHOCARDIOGRAPHYS

http://www.youtube.com/watch?v=UCp8061yo5Q
http://www.youtube.com/watch?v=GiiEbGK9kI8
Conventional PLAX view. This view shows no apparent mitral valve disease Parasternal long axis view with mild rotation of the transducer. A mass in mitral valve is clearly seen

 

http://www.youtube.com/watch?v=25qWca_r77s
http://www.youtube.com/watch?v=GIqvIjZInnU
Parasternal long axis view with mild rotation of the transducer. Zoom on mitral valve to show the abnormal mass. In this clinical context the mass is compatible to endocarditic vegetation Parasternal long axis view with colour Doppler. Swirling pattern in left atrium suggestive of mitral regurgitation

 

http://www.youtube.com/watch?v=jHJ6tzJ2GFs
http://www.youtube.com/watch?v=3i3G9gr6lu0
Apical 4 chambers view. Notice the mass in the posterior mitral valve leaflet Colour Doppler on apical 4 chambers view showing mitral valve regurgitation

 

http://www.youtube.com/watch?v=3lnCVhk3AMw
http://www.youtube.com/watch?v=kKm8bkJ5_I0
Apical 3 chambers view. Notice the mass in the posterior mitral valve leaflet Colour Doppler on apical 4 chambers view showing mitral valve regurgitation

 

http://www.youtube.com/watch?v=9LJDWxgaHcM<
Colour Doppler on apical 4 chambers view showing mitral valve regurgitation

 

Severe mitral regurgitation – assessment with continuous wave Doppler

Conclusion

Diagnosis and management

  • Blood cultures: staphylococcus aureus
  • Diagnosis: Mitral infective endocarditis. Severe mitral regurgitation
  • On antibiotics for endocarditis
  • After 6 weeks, no progress > patient underwent successful mitral valve replacement with a mechanical prosthesis