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Staphylococcus Aureus Mitral Valve Endocarditis

EACVI Valvular Imaging Box

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

Echocardiography

 

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

 

 

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

 

 

Apical 4 chambers view. Notice the mass in the posterior mitral valve leaflet

 

 

Colour Doppler on apical 4 chambers view showing mitral valve regurgitation

 

 

Apical 3 chambers view. Notice the mass in the posterior mitral valve leaflet

 

 

Colour Doppler on apical 4 chambers view showing mitral valve regurgitation

 

 

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