RT Journal Article
T1 Infective endocarditis on interventricular communication as cause of massive haemoptysis: a case report.
A1 Rodríguez Torres, Diego José
A1 Rodríguez, Diego Segura
A1 Escobar, Eduardo Moreno
A1 Orta, Rocío García
K1 Case report
K1 Congenital heart malformation
K1 Endocarditis
K1 Haemoptysis
AB Haemoptysis is a rare symptom associated with endocarditis. We describe the unusual clinical manifestation of endocarditis on regurgitant bicuspid aortic valve and (probably) secondarily on a perimembranous ventricular septal defect (VSD) as massive haemoptysis. A 24-year-old male with aortic coarctation, bicuspid aortic valve, and VSD since birth. Previously asymptomatic, he came after an episode of haemoptysis. A computed tomography (CT) scan showed a cavitated lesion in lung. Streptococo viridans was identified in serial blood cultures. Transthoracic echocardiography showed a bicuspid aortic valve with vegetations, suggesting infectious involvement, and severe aortic insufficiency. Transoesophageal echocardiography (TEE) study showed a bicuspid aortic valve with complete fusion of coronary valves. An elongated oscillating tumour, 9.5 mm in length, was observed in the centre of the ventricular side of the non-coronary valve. Another vegetation was seen on the VSD. During his hospital stay and under antibiotic treatment, he reported abdominal pain. Computed tomography examination showed splenic infarction. In the echocardiogram no vegetation masses were observed on the aortic valve or on the VSD closure aneurysm. The main debate about this patient's treatment concerned the indication of surgery, especially after the onset of fever with splenic septic embolism while under appropriate antibiotic treatment. He was stable, with no signs of heart failure and the echocardiogram repeated after the septic splenic embolism showed no residual vegetations on the aortic valve or VSD, and the TEE study ruled out a local complication. Finally, the multidisciplinary team decided against surgical management.
YR 2022
FD 2022-09-05
LK http://hdl.handle.net/10668/19761
UL http://hdl.handle.net/10668/19761
LA en
DS RISalud
RD Apr 17, 2025