Related Experiment Videos
Bacterial endocarditis of the mitral valve associated with annual calcification
Abstract:
Bacterial endocarditis, caused mainly by Staphylococcus aureus, was found at autopsy in five patients who had a calcified posterior mitral valve annulus. Clincopathologic correlation indicates that the infection should be suspected in elderly patients with a calcified mitral annulus, the murmur of mitral insufficiency, fever, anemia, polymorphonuclear leukocytosis and a positive blood culture, regardless of evidence of peripheral embolism or of another disease that could cause the last four features. Pertinent pathologic findings are a calcified mitral valve annulus, vegetations of bacterial endocarditis towards the base of the posterior leaflet associated with leaflet perforation and an annulus abscess, and no other valvular disease. The infection may develop on the atrial aspect of a leaflet ulcerated by the calcium mass or may begin on its ventricular aspect, subsequently perforating the leaflet and infecting its atrial surface.
Insights
Bacterial endocarditis can occur in elderly patients with a calcified mitral annulus. This condition, often caused by Staphylococcus aureus, presents with specific clinical signs and autopsy findings.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathology
Background:
- Calcified posterior mitral valve annulus is a risk factor for bacterial endocarditis.
- Staphylococcus aureus is a primary causative agent in these cases.
- Elderly patients with specific clinical signs may present with this condition.
Purpose of the Study:
- To investigate the association between calcified mitral annulus and bacterial endocarditis.
- To identify key clinical and pathological features for diagnosing this infection.
- To understand the pathogenesis of endocarditis in this specific patient group.
Main Methods:
- Autopsy findings in five patients with calcified posterior mitral valve annulus and bacterial endocarditis.
- Clinicopathologic correlation of clinical signs and pathological evidence.
- Histopathological examination of mitral valve annulus and leaflets.
Main Results:
- Bacterial endocarditis, primarily Staphylococcus aureus, was identified in five patients with calcified posterior mitral valve annulus.
- Key findings include vegetations at the base of the posterior leaflet, leaflet perforation, and annulus abscess.
- Infection can originate from either the atrial or ventricular aspect of the leaflet.
Conclusions:
- Bacterial endocarditis should be suspected in elderly patients with a calcified mitral annulus and signs of mitral insufficiency.
- Clinical suspicion should be raised with fever, anemia, leukocytosis, and positive blood cultures, even without peripheral embolism.
- Pathological findings confirm the role of calcification in leaflet ulceration and subsequent infection.