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Postoperative dyspnoea

Jason R Sims1, Maurice Enriquez-Sarano2, Hector I Michelena2

  • 1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Heart (British Cardiac Society)
|September 17, 2016
PubMed
Abstract

Insights

A patient developed severe heart failure symptoms shortly after aortic valve replacement for Staphylococcus aureus endocarditis. Diagnosis was aortic valve dehiscence with severe paraprosthetic regurgitation, requiring further intervention.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Aortic valve endocarditis caused by methicillin-sensitive Staphylococcus aureus necessitates prompt treatment.
  • Surgical intervention with bioprosthetic aortic valve replacement is a standard approach for abscessed aortic valve endocarditis.

Observation:

  • A 50s male presented with severe dyspnea, edema, and elevated C-reactive protein 18 days post-aortic valve replacement.
  • Physical examination revealed signs of heart failure, including tachypnea, tachycardia, prominent neck CV waves, and a holosystolic murmur.
  • Transthoracic echocardiogram (TTE) was performed to evaluate cardiac function and valve integrity.

Findings:

  • The clinical presentation and TTE findings are suggestive of a specific complication post-aortic valve surgery.
  • Differential diagnoses include tricuspid regurgitation, aortic valve obstruction, acquired Gerbode defect, and aortic valve dehiscence with paraprosthetic regurgitation.

Implications:

  • Accurate diagnosis is crucial for timely and appropriate management of post-cardiac surgery complications.
  • Early identification of prosthetic valve dysfunction can prevent further cardiac damage and improve patient outcomes.
  • This case highlights the importance of comprehensive echocardiographic assessment in patients with suspected prosthetic valve endocarditis complications.

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