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Mitral obstruction in bacterial endocarditis.

P K Ghosh, H I Miller, B A Vidne

    British Heart Journal
    |March 1, 1985
    PubMed
    Summary
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    Acute Streptococcus viridans endocarditis caused severe mitral obstruction in a 47-year-old man. Despite rapid vegetation growth documented by echocardiography, emergency surgery was too late to prevent fatal septic shock.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Cardiac Surgery

    Background:

    • Infective endocarditis is a serious infection of the heart valves.
    • Streptococcus viridans is a common causative agent of endocarditis.
    • Large vegetations can lead to significant hemodynamic compromise.

    Observation:

    • A 47-year-old male presented with acute Streptococcus viridans endocarditis.
    • Echocardiography revealed a large mitral valve vegetation causing obstruction.
    • Serial imaging demonstrated rapid vegetation growth and its impact on hemodynamics.

    Findings:

    • The patient experienced severe mitral obstruction due to the rapidly growing vegetation.
    • Hemodynamic effects of the vegetation were significant, leading to septic shock.

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  • Emergency mitral valve replacement was ultimately unsuccessful in reversing the fatal outcome.

    • Implications:

    • This case highlights the critical need for prompt diagnosis and intervention in severe infective endocarditis.
    • Rapid vegetation growth can portend a poor prognosis despite surgical intervention.
    • Understanding the hemodynamic impact of vegetations is crucial for timely management decisions.