Cardiovasc Imaging Asia.  2024 Jul;8(3):57-60. 10.22468/cvia.2024.00045.

The Crucial Role of Repeated Pre-Operative Echocardiography in Detecting Spontaneous Resolution of Infective Endocarditis in a Patient With Multiple Strokes

• Kim GR
• Ko KY
• Kim SE
• Hwang JW
• Kwak JJ
• Cho SW

• KMID: 2558379
• DOI: http://doi.org/10.22468/cvia.2024.00045

Abstract

We present a case study of a 40-year-old man diagnosed with infective endocarditis (IE) who was admitted with fever and multiple cerebral infarctions. Echocardiography identified a 2.2× 1.7-cm-sized mass attached to the endocardium of the left ventricle and chordae of the mitral valve. Fulfilling the Duke criteria for definite IE, he was started on intravenous antibiotics. Despite uncompromised valve function, the potential risk of further embolization necessitated planned open-heart surgery. Yet, follow-up echocardiography just prior to surgery surprisingly showed that the vegetation had resolved, leading to cancellation of the planned surgery. After one month of antibiotic treatment, the patient was discharged without any issues. This case emphasizes the critical role of a final echocardiographic assessment before surgery in an IE patient, as it may prevent unnecessary surgical intervention.

Keyword

Infective endocarditis; Embolism; Echocardiography