Absent pericardium: at risk for endocarditis?

Area of Science:

• Cardiology
• Congenital Anomalies
• Infectious Diseases

Background:

• Endocarditis is a serious infection of the heart's inner lining, often affecting the valves.
• Congenital absence of the pericardium is a rare anomaly with varied presentations.
• The association between pericardial defects and endocarditis has not been previously established.

Observation:

• A 16-year-old female presented with septic shock and was diagnosed with mitral valve endocarditis.
• Surgical findings revealed a large left atrial appendage herniation into the left pleural cavity.
• This herniation was attributed to a partial absence of the pericardium.

Findings:

• The case suggests a potential, previously unrecognized link between absence of the pericardium and endocarditis.
• The anatomical defect may predispose individuals to cardiac infections like endocarditis.
• This finding challenges the current understanding of endocarditis risk factors.

Implications:

• Further investigation is warranted to explore the mechanism connecting pericardial absence and endocarditis.
• Consideration should be given to endocarditis prophylaxis in patients diagnosed with congenital pericardial defects.
• This case broadens the differential diagnosis for endocarditis in the presence of rare congenital anomalies.