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