Bacterial endocarditis of the pulmonic valve: Association with atrial septal defect of the ostium secundum type∗

Abstract

An unusual case of “right-sided bacterial endocarditis” is reported with a brief review of the literature. Fever, changing heart murmurs over the pulmonic area and scattered pulmonary infiltrates were the main clinical features. At surgery, a large secundum atrial septal defect was found in addition to a large vegetation on the right cusp of the pulmonic valve.The possibility of an acquired stenosis of the pulmonary valve secondary to proliferative bacterial endocarditis is suggested. This could explain the elevated systolic pulmonary valve gradient, in the absence of the typical congenital fusion of the pulmonary cusps.