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Ruptured Aortic Valve Aneurysm Caused by Infective Endocarditis in a SARS-CoV-2-Positive Autopsy Case

Shojiro Takasu1, Sari Matsumoto, Yuko Kanto

  • 1From the Department of Forensic Medicine, The Jikei University School of Medicine, Tokyo, Japan.

The American Journal of Forensic Medicine and Pathology
|August 12, 2024
PubMed

Insights

A rare aortic valve aneurysm ruptured, causing fatal heart failure in a patient with COVID-19. This case highlights a potential link between SARS-CoV-2 infection and infective endocarditis complications.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathology

Background:

  • Aortic valve aneurysm is a rare complication of infective endocarditis (IE).
  • Coronavirus disease 2019 (COVID-19) can lead to cardiovascular issues and increase susceptibility to secondary infections like IE.

Purpose of the Study:

  • To report a fatal case of IE with aortic valve aneurysm rupture in a patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
  • To explore the potential association between SARS-CoV-2 and IE-related cardiovascular complications.

Main Methods:

  • Autopsy examination of a 67-year-old male with heart failure symptoms.
  • Histological analysis of the aortic valve, including Gram staining.
  • Reverse transcription quantitative polymerase chain reaction (RT-qPCR) for SARS-CoV-2 detection.

Main Results:

  • Autopsy revealed a ruptured aortic valve aneurysm with vegetation, cusp destruction, and an abscess.
  • Gram staining identified a gram-positive coccus.
  • RT-qPCR confirmed SARS-CoV-2 positivity. No other IE risk factors were identified.

Conclusions:

  • The findings suggest a likely association between SARS-CoV-2 infection and infective endocarditis complicated by aortic valve aneurysm rupture.
  • This case underscores the severe cardiovascular sequelae that can arise from COVID-19, including rare but fatal complications.

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