J Korean Soc Echocardiogr.  1994 Jul;2(1):109-112. 10.4250/jkse.1994.2.1.109.

An Infective Endocarditis with Abscess Formation not Accompanied with Heart Failure

• Moon TH
• Koh KK
• Kim EJ
• Park TB
• Cho CH
• Cho SK
• Kim SS
• Kim MH
• Chin SH
• Park CS
• Suh CH

• KMID: 2410467
• DOI: http://doi.org/10.4250/jkse.1994.2.1.109

Abstract

Heart failure is the most common cause of death of infective endocarditis. The contributing factors of heart failure include valve destruction, myocarditis, coronary artery emboli with myocardial infarction and abscess. Recently, we experienced a thiry nine year-old man who was hospitalized at Inha University Hospital because of fever, chill and dyspnea (NYHA functional class I-II). The grade IV/Vi systolic murmur was heard at the right upper sternal border and the apex and the grade III/VI diastolic murmur was heard at Erb's area. No crackles were heard. Blook cultures grew Streptococcus viridans. Chest X-ray showed mild cardiomegaly without pulmonary congestion sign. Echocardiogram showed aortic valve vegetations, abscess and grade II/IV aortic regurgitation. Aortic valve replacement and abscess removal were performed. Findings included henegg sized abscess which reduced 70% of cross sectional area of left ventricular outflow tract and located between posterior wall of left ventricle and right and left coronary rings.

Keyword

Infective endocarditis; Abscess; Heart failure

MeSH Terms

Abscess*
Aortic Valve
Aortic Valve Insufficiency
Cardiomegaly
Cause of Death
Coronary Vessels
Dyspnea
Endocarditis*
Estrogens, Conjugated (USP)
Fever
Heart Failure*
Heart Murmurs
Heart Ventricles
Heart*
Myocardial Infarction
Myocarditis
Respiratory Sounds
Systolic Murmurs
Thorax
Viridans Streptococci
Estrogens, Conjugated (USP)

Figure

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  Fig. 1. Chest roentgenogram showing mild cardiomegaly.

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  Fig. 2A and B. Echocardiogram showing echo-free space(AB) and vegetation(VG). (RA: right atrium, LA: left atrium, LV: left ventricle, AV: aortic valve, TV: tricuspid valve, RVOT: right ventricular outflow tract, VS: ventricular septum, AB: abscess, VG: vegetation).

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  Fig. 3. Extracted specimen.

Reference

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