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Acquired Gerbode Defect in a Patient With Infective Endocarditis of Bicuspid Aortic Valve
Mohammed Mahdi1, Muhammet Ozer1, Bipinpreet Nagra2
1Internal Medicine, Capital Health Regional Medical Center, Trenton, USA.
Cureus
|July 9, 2021
Summary
Aortic valve abscess, a severe infective endocarditis complication, can be missed by initial echocardiography. This case highlights a Streptococcus agalactiae infection with abscess and Gerbode defect mimicking tricuspid valve vegetation.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Aortic valve abscess is a life-threatening complication of IE.
- Transthoracic echocardiography (TTE) is the first-line imaging for suspected IE, but has limitations in detecting subtle cardiac complications.
Observation:
- This case involves a bicuspid aortic valve infected by Streptococcus agalactiae.
- The patient developed an aortic valve abscess and an acquired Gerbode defect.
- Initial transthoracic echocardiography revealed findings suggestive of a tricuspid valve vegetation.
Findings:
- The aortic valve abscess and Gerbode defect were confirmed as complications of infective endocarditis.
- Streptococcus agalactiae was identified as the causative pathogen.
- Transthoracic echocardiography findings were misleading, mimicking a different cardiac anomaly.
Implications:
- Transesophageal echocardiography (TEE) is crucial for accurate diagnosis when TTE is inconclusive or clinical suspicion is high.
- Early and accurate diagnosis of aortic valve abscess and associated defects is vital for timely intervention.
- This case underscores the importance of considering advanced imaging in complex IE cases, especially with atypical presentations.
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