•  
  •  
 

Author Credentials

George M. Yousef, MD, Paul I. Okhumale, MD, Haytham Aljoudi, MD, Silvestre Cansino, MD

DOI

http://dx.doi.org/10.18590/mjm.2017.vol3.iss1.8

Abstract

A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari's network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case.

Conflict(s) of Interest

N/A

References with DOI

1. Pant S1, Patel NJ2, Deshmukh A3, Golwala H1, Patel N4, Badheka A5, Hirsch GA1, Mehta JL6. Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011. J Am Coll Cardiol. 2015;65:2070-2076. https://doi.org/10.1016/j.jacc.2015.03.518

2. Johri AM, Kovacs KA, Kafka H. An unusual case of infective endocarditis: extension of a tricuspid valve vegetation into the left atrium through a patent foramen ovale. Can J Cardiol 2009; 25(7):429-431. https://doi.org/10.1016/s0828-282x(09)70515-x

3. Bru P, Iacono C, Collet F, Vaillant A, Malméjac C, Belhadj M, Houël J. Tricuspid endocarditis with rightleft shunt in the atrium. Arch Mal Coeur Vaiss. 1986 Apr;79(4):511-3.

4. Morelon P, Eicher JC, Chavanet P, Diebold H, Coudert B, Portier H, David M, Louis P. Tricuspid endocarditis with right-left auricular shunt through a patent foramen ovale]. Ann Cardiol Angeiol (Paris). 1987 Jan;36(1):23-6.

5. Turek MA, Karovitch A, Aaron SD, Brais M. Persistent hypoxemia occurring as a complication of tricuspid valve endocarditis. J Am Soc Echocardiogr. 2000 May;13(5):412-4. https://doi.org/10.1016/s0894-7317(00)70012-5

6. Gans CP, Kao JA. Tricuspid regurgitation causing a right to left interatrial shunt with normal pulmonary pressures. Cardiology. 2007;107(4):429-32. https://doi.org/10.1159/000099654

7. Chiari H. Über Netzbildungcn im rechten Vorhof des Herzens. Beitr Pathol Anat. 1897;22:1-10.

8. Schneider B, Hofmann T, Justen MH, Meinertz T. Chiari's network: Normal anatomic variant or risk factor for arterial embolic events?. J Am Coll Cardiol. 1995;26(1):203-210. https://doi.org/10.1016/0735-1097(95)00144-o

9. Gregory Sueroa, b, Rekhi Varghesea, Moneal Shaha, David Lasordaa. Embolic brain abscess in a patient with tricuspid valve endocarditis and a patent foramen ovale. J Neurol Res. 2012;2(3):123-126.

10. Makdisi G, Casciani T, Wozniak TC, Roe DW, Hashmi ZA. A successful percutaneous mechanical vegetation debulking used as a bridge to surgery in acute tricuspid valve endocarditis. J Thorac Dis. 2016 Jan;8(1):E137-9.

Share

COinS