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07-02-2020 | Heart Beat | Uitgave 10/2020 Open Access

Netherlands Heart Journal 10/2020

Pulmonary valve infective endocarditis with atrial septal defect and pulmonary valve disease—too coincidental to be true?

Netherlands Heart Journal > Uitgave 10/2020
M. W. L. Smits, R. Tukkie, P. G. Meregalli, D. Robbers-Visser, P. T. G. Bot
In this case we describe a 68-year-old male patient who presented with malaise after being treated for a urinary tract infection caused by enterococcus faecalis. The electrocardiogram showed atrial fibrillation and subsequent transthoracic echocardiography revealed a mobile structure on the pulmonary valve with an increased transpulmonary valve gradient (Fig.  1). Blood cultures were positive for enterococcus faecalis and PET-CT revealed F‑18-fluorodeoxyglucose (FDG) uptake in the right ventricular outflow tract and lungs.
Transoesophageal echocardiography revealed a previously unknown small atrial septal defect type 2 with left-to-right shunt as well as a moderate pulmonary valve stenosis and severe regurgitation (Fig.  2).
In the majority of cases, right-sided infective endocarditis involves the tricuspid valve and is associated with intravenous drug use or the presence of pacemakers [ 13]. In this case, a type 2 atrial septal defect and a dysplastic pulmonary valve were observed. This case underscores the importance of thorough investigation of coexistent congenital heart defects in cases of right-sided infective endocarditis [ 4].
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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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