Tamponade Hemopericardium due to Mitral Annulus Abscess Rupture

Area of Science:

• Cardiology
• Pathology
• Infectious Diseases

Background:

• Mitral annulus abscesses are uncommon cardiac emergencies.
• Abscesses on native heart valves without vegetations are particularly rare.
• Cardiac rupture from mitral annulus abscesses is a theoretically possible but rarely reported fatal complication.

Purpose of the Study:

• To report a unique case of fatal cardiac rupture caused by a mitral annulus abscess.
• To discuss the infrequent occurrence and potential lethal outcomes of this condition.

Main Methods:

• Autopsy and histopathological examination of a deceased patient.
• Microbiological investigation to identify the causative agent.

Main Results:

• The autopsy revealed tamponade hemopericardium and perforation of the left atrio-ventricular wall due to a mitral annulus abscess.
• Severe mitral annulus calcification was noted.
• Histology confirmed the abscess with peri-abscess endocarditis.
• Staphylococcus epidermidis was identified as the causative microorganism.

Conclusions:

• This case represents a rare instance of mitral annulus abscess leading to cardiac rupture and death.
• The findings underscore the importance of considering rare cardiac pathologies in unexplained sudden deaths, even in the absence of typical signs like valve vegetations.