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Mitral valve prolapse: jet stream causing mural endocarditis.

M Ringer, D J Feen, M S Drapkin

    The American Journal of Cardiology
    |February 1, 1980
    PubMed
    Summary
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    A patient with Streptococcus mutans endocarditis developed cerebral hemorrhage. Autopsy revealed endocarditis on the left atrial wall, linked to mitral valve prolapse and chordae tendineae rupture, confirming endocarditis pathogenesis concepts.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Pathology

    Background:

    • Streptococcus mutans is a common cause of infective endocarditis.
    • Mitral valve prolapse and mucinous degeneration can predispose to cardiac complications.
    • Cerebral hemorrhage is a serious potential complication of infective endocarditis.

    Observation:

    • A 53-year-old male patient with Streptococcus mutans endocarditis experienced a fatal cerebral hemorrhage.
    • Autopsy revealed the sole endocarditic lesion on the left atrial mural endocardium.
    • The noninfected mitral valve showed prolapse and mucinous degeneration, leading to chordae tendineae rupture.

    Findings:

    • The rupture of chordae tendineae created a jet stream.
    • This jet stream impacted the left atrial endocardium, predisposing it to endocarditis.

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  • The case confirms the understanding of endocarditis pathogenesis.

    • Implications:

    • The findings reinforce current concepts regarding the development of infective endocarditis.
    • Understanding the specific pathogenesis in this case has therapeutic implications for managing similar conditions.
    • Highlights the importance of evaluating underlying cardiac structural abnormalities in endocarditis patients.