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A rare case of native mitral valve infective endocarditis presenting with complete heart block and intermittent

Pravin Thomas1, Shahryar Ansari1, Ahmed A Elkhouly1

  • 1Internal Medicine Department, Seton Hall University School of Health and Medical Sciences, Trenton, New Jersey, USA.

Journal of Community Hospital Internal Medicine Perspectives
|April 23, 2021
PubMed

Insights

Mitral valve infective endocarditis, a rare cause of complete heart block, can occur without aortic valve involvement. This case highlights Staphylococcus Aureus endocarditis leading to heart block and a junctional escape rhythm.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Electrophysiology

Background:

  • Infective endocarditis (IE) can affect heart valves, potentially leading to complications.
  • Complete heart block (CHB) is a serious cardiac condition affecting electrical conduction.
  • Mitral valve IE is less commonly associated with CHB compared to other forms.

Observation:

  • A rare case of CHB with a junctional escape rhythm was observed.
  • The patient presented with a Staphylococcus Aureus vegetation solely on the native mitral valve.
  • No concurrent aortic valve involvement was detected.

Findings:

  • Mitral valve IE, isolated from aortic involvement, is an infrequent cause of CHB.
  • Literature review identified six similar cases of mitral valve IE with CHB and no aortic involvement.
  • This case adds to the understanding of IE's impact on cardiac conduction systems.

Implications:

  • Understanding the proximity of valvular infections to the cardiac conduction system is crucial.
  • This emphasizes the need for vigilance in diagnosing and managing mitral valve IE, even without aortic involvement.
  • Further research may elucidate specific mechanisms linking mitral valve IE to conduction abnormalities.
Keywords:
Mitral Valve infective endocarditisheart blockjunctional rhythm

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