Abstract
Introduction: To report a case of isolated “endocarditic” aortic regurgitation in a 17-year old female with infective vegetations on aortic valve. Case Report: A 17-year old female was admitted with features of heart failure and a febrile illness. Blood cultures were negative and ECG revealed normal. Echocardiography revealed a “kissing-type” of vegetation on the bicuspid aortic valve with severe aortic regurgitation and a dilated left ventricle with moderate dysfunction. Conclusion: The management of aortic insufficiency occurring in infective endocarditis may differ and the presence of intractable pulmonary edema or shock is a clear indication for prompt valve replacement. The traditional diagnostic criteria are insufficient to diagnose infective endocarditis and the modified Duke criteria provide high sensitivity and specificity over 80% for the diagnosis of native valve endocarditis with positive blood cultures.
Highlights
To report a case of isolated “endocarditic” aortic regurgitation in a 17-year old female with infective vegetations on aortic valve
The management of aortic insufficiency occurring in infective endocarditis may differ and the presence of intractable pulmonary edema or shock is a clear indication for prompt valve replacement
Aortic valve replacement (AVR) can be safely and effectively accomplished during the course of active infective endocarditis and that urgent valve replacement should be considered [47] in patients who develop heart failure due to valve destruction
Summary
Infective endocarditis is a microbial infection of a heart valve (native or prosthetic) or the mural endocardium, leading to tissue destruction and formation of vegetation. Isolated aortic regurgitation was found in only one-twenteeth of a large series of patients in India, 2.7% of patients under 19 years in Brazil as a unique valvular dysfunction. Infective endocarditis of aortic valve is a major cause of isolated acute aortic regurgitation [5] and so this case had been reported
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