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Unusual cardiac complications of Staphylococcus aureus endocarditis

Chandra Kunavarapu1, Yefin Olkovsky, James C Lafferty

  • 1Department of Cardiology, Medical College of Georgia, Augusta, Georgia 30912, USA. ckunavarapu@mcg.edu

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|August 9, 2007
PubMed

Insights

Staphylococcus aureus endocarditis can cause severe cardiac issues, even with treatment. This case highlights rare complications like coronary artery aneurysms and left ventricle-left atrium fistulas in an immunocompromised patient.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Case Reports

Background:

  • Bacterial endocarditis, particularly Staphylococcus aureus infective endocarditis, presents significant morbidity and mortality.
  • Acute bacterial endocarditis can lead to severe complications despite appropriate medical management.

Observation:

  • An immunocompromised patient presented with acute Staphylococcus aureus bacterial endocarditis.
  • The patient developed multiple, unusual cardiac complications.

Findings:

  • Complications included bacterial pericarditis with effusion, a mycotic coronary artery aneurysm, and valvular vegetation.
  • Aneurysmal dilatation at the mitral-aortic junction (intervalvular fibrosa) and a left ventricle-to-left atrium fistula were identified.
  • Echocardiography revealed these anomalies, confirmed intraoperatively.

Implications:

  • This case underscores the potential for severe and rare cardiac complications in Staphylococcus aureus endocarditis, especially in immunocompromised individuals.
  • Surgical intervention, including pericardial patch repair, was necessary for managing these complex cardiac anomalies.
  • Highlights the importance of comprehensive diagnostic imaging and timely surgical management in complex endocarditis cases.

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