Virtually All Complications of Active Infective Endocarditis Occurring in a Single Patient
Section snippets
Case Description
A 49-year-old black man with known advanced polycystic renal disease on hemodialysis (for 6 years), diabetes mellitus, systemic hypertension, and obstructive sleep apnea (without obesity—body weight 176 lbs.) had been in his usual health until he developed epigastric, back, and vague chest pain 3 days before hospitalization. Examination in the emergency room disclosed a grade 2/6 systolic murmur along the lower left sternal border. The patient indicated that his chest pain worsened when lying
Discussion
Of the various cardiac valves affected by infective endocarditis, the aortic by far is the most common and it also is associated with the most complications.1 Chronic renal disease, as in the present patient is a major risk factor for infective endocarditis.2 These complications include destruction of the aortic valve cusps causing aortic regurgitation, extension of the cuspal infection to adjacent tissues (ring abscess), including the anterior mitral leaflet and its chordae tendinea producing
References (2)
- et al.
Comparison of active infective endocarditis involving a previously stenotic versus a previously nonstenotic aortic valve
Am J Cardiol
(1993) - et al.
Cardiac findings at necropsy in patients with chronic kidney disease maintained on chronic hemodialysis
Medicine (Baltimore)
(2012)