Left Ventricular-Right Atrial Shunt Due to Bacterial Endocarditis

Abstract

Two patients are reported who developed perforation of the ventricular septum resulting in a left ventricular-right atrial shunt, as a complication of bacterial endocarditis. One of these patients presented with catastrophic cardiac deterioration, shock and biventricular failure, while in the other the defect was small and of little hemodynamic significance. With regard to differential diagnosis, note is made of the pansystolic murmur, the prominent venous pressure elevation and the absence of radiographic findings of marked pulmonary edema. Two patients are reported who developed perforation of the ventricular septum resulting in a left ventricular-right atrial shunt, as a complication of bacterial endocarditis. One of these patients presented with catastrophic cardiac deterioration, shock and biventricular failure, while in the other the defect was small and of little hemodynamic significance. With regard to differential diagnosis, note is made of the pansystolic murmur, the prominent venous pressure elevation and the absence of radiographic findings of marked pulmonary edema.