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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 339:459-466 August 13, 1998 Number 7
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Case 25-1998— A 34-Year-Old Man with New Mitral Regurgitation after Aortic-Valve Replacement for Bacterial Endocarditis
Patrick T. O'Gara, Navneet Narula, and Eugene J. Mark

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Presentation of Case

A 34-year-old man was admitted to the hospital because of worsening dyspnea and increasing mitral regurgitation after replacement of the aortic valve for acute bacterial endocarditis.

The patient had a history of intravenous drug abuse. Four months before admission he had been transferred to this hospital because of acute bacterial endocarditis caused by Staphylococcus aureus, with aortic regurgitation. A test for antibodies to the human immunodeficiency virus was negative. A transesophageal ultrasonographic examination of the heart (Figure 1) revealed a large prolapsing vegetation on the right coronary cusp of the aortic valve, with severe aortic regurgitation; there was . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Patrick T. O'Gara's Diagnosis

Pathological Discussion

Anatomical Diagnosis

References




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