[Reversible contact lesion in mitral valve endocarditis--follow-up study with transesophageal echocardiography]

This is a case report of a 59-year-old patient with an endocarditis of the mitral valve caused by streptococcus viridans. Precordial echocardiography showed a highly mobile vegetation of the anterior mitral leaflet prolapsing during systole into the left atrium. During diastole contact with the ventricular septum caudally to the left ventricular outflow tract was noted. By using transesophageal echocardiography (TEE), this zone appeared as a localized increased echogenity of the parietal endocardium and underlying myocardium. Antibiotic therapy led to a cure of the endocarditis (clinically and according to clinical chemistry). The TEE follow-up 2 months later showed persisting mitral valve vegetation, whereas neither the endocardial lesion nor the abnormal myocardial echo pattern were seen any longer. The likely inflammatory etiology of the described lesion is discussed and seems obvious.