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Updated: Sep 17, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
New Mitral Regurgitation Unveiling Infective Endocarditis in an Adolescent With Mitral Valve Prolapse
Adelaide Iervolino1, Monica Barki2, Giacomo Ingallina2
1Cardiovascular Imaging Unit, Cardiothoracic Department, IRCCS San Raffaele Hospital, Milan, Italy; Cardiovascular Pathophysiology and Therapeutics PhD Program, Federico II University Hospital, Naples, Italy.
Background:
Infective endocarditis (IE) is a potentially life-threatening condition, possibly occurring in overlap with preexisting structural cardiac abnormalities. The Duke Criteria represent a cornerstone in the diagnosis of IE, and the detection of new regurgitation represents a major criterion that may be overlooked.
Case Summary:
We present a case of a 14-year-old girl with mitral valve prolapse (MVP) who developed IE. Despite initial negative echocardiographic findings for vegetations, thorough analysis revealed the presence of a new regurgitation jet at P3 scallop, thereby distinguishing it from the mild preexisting central mitral regurgitation.
Discussion:
This case highlights the diagnostic challenges of IE when vegetations are absent on echocardiography. In this setting, recognizing a new jet from a preexisting regurgitation is crucial in making the diagnosis.
Take-Home Messages:
Echocardiography represents the cornerstone for diagnosing IE. Indeed, in patients with MVP, careful assessment of new regurgitation, even in the absence of visible vegetations, should raise suspicion for IE.
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Mitral Regurgitation I: Introduction
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Mitral Valve Prolapse I: Introduction
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral Stenosis III: Medical Management

