Abstract
Left ventricular rupture and formation of a pseudoaneurysm is a well-recognized complication after mitral valve replacement. With an incidence of ≈1.2%, it is extremely rare and potentially fatal.1 We describe such a case in the setting of infective endocarditis. A 47-year-old man came into casualty reporting fever, chest pain, and shortness of breath. His history included 25 years as an intravenous drug user, injecting heroin and methadone, and being positive for hepatitis C. He had recently experienced an abscess in the groin after the use of this site for injection. On examination, he was found to be pyrexial (39.4°C) and tachycardic, with a blood pressure of 142/97 mm Hg. He had a harsh apical pansystolic murmur, nail fold infarcts, and splinter hemorrhages in his hands and feet. Blood tests showed a C-reactive protein count of 236 mg/L and a white cell count of 6.8×109, with the differential being …
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