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Triple Valve Endocarditis With Aortic Root Abscess Presenting With Complete Heart Block and Distal Embolization
Mitra Patel1, Zeid Nesheiwat1,2, Neha Patel1
1Internal Medicine, University of Toledo College of Medicine, Toledo, USA.
Cureus
|April 19, 2021
Summary
Infective endocarditis (IE) with multiple valve involvement has a poor prognosis. Early diagnosis via transesophageal echocardiography (TEE) is crucial for timely intervention and improved outcomes in high-risk patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Infective endocarditis (IE) presents a significant mortality risk, particularly when multiple heart valves are affected.
- Early diagnosis and management of IE are clinically challenging due to its poor prognosis.
Observation:
- A case study details a 45-year-old male with bacteremia from a diabetic foot ulcer, presenting with complete heart block.
- Initial transthoracic echocardiogram (TTE) revealed vegetations on the aortic and mitral valves.
- Transesophageal echocardiogram (TEE) identified an aortic valve abscess and vegetations on the mitral and tricuspid valves, with the tricuspid involvement missed by TTE.
Findings:
- Transesophageal echocardiography (TEE) is highly effective in detecting subtle and early mechanical complications of infective endocarditis.
- Multi-valve endocarditis significantly elevates patient risk for severe complications.
Implications:
- Prompt TEE utilization is imperative for rapid clinical decision-making and early intervention in suspected IE.
- Patients with multi-valve endocarditis require immediate evaluation for surgical intervention due to their extremely high risk profile.
Keywords:
endocarditis
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