scholarly journals Infective endocarditis of an aortic bioprosthesis causing life-threatening incessant junctional tachycardia: a case report

Author(s):  
Quentin Chatelain ◽  
Andrea Carcaterra ◽  
Florian Rey ◽  
Haran Burri

Abstract Background  Infective endocarditis with paravalvular abscess can be complicated by atrioventricular block (AVB), but junctional ectopic tachycardia (JET) has as yet never been described. Case summary  A 68-year-old male recently admitted with Staphylococcal aureus endocarditis of his aortic valve bioprosthesis, presented with a regular tachycardia at 240 b.p.m. with a pre-existent right bundle branch block pattern. Haemodynamic collapse necessitated electrical cardioversion, following which high-grade AVB was observed. Multiple recurrences of the same tachycardia required repeated electrical cardioversions and emergent electrophysiological study, which indicated JET. The tachycardia was unresponsive to overdrive pacing, adenosine and intravenous amiodarone, and external cardioversions. Radiofrequency catheter ablation of the atrioventricular node was performed emergently with interruption of the tachycardia. A temporary external pacemaker was implanted via a jugular route. The tachycardia recurred after 48 h at a slower rate, and the patient underwent redo ablation. Transoesophageal echocardiography revealed a pseudoaneurysm of the right sinus of Valsalva probably corresponding to an evacuated abscess. A permanent pacemaker was implanted after active infection had been ruled out. At 3 months of follow-up, the patient had complete AVB, without arrhythmia recurrence. Discussion  This is the first case report of JET complicating a paravalvular abscess of the aortic valve with concomitant AVB. Junctional ectopic tachycardia is very rare arrhythmia which is usually seen in children as a congenital arrhythmia or following surgical correction of paediatric heart disease. The differential diagnosis is discussed in detail in the article.

2017 ◽  
Vol 99 (2) ◽  
pp. e54-e55 ◽  
Author(s):  
A-C Pinho-Gomes ◽  
A Nasir ◽  
R Mosca ◽  
S Mirza ◽  
I Kadir

We report the first case of infective endocarditis caused by Paenibacillus provencensis. A mitral valve vegetation was incidentally discovered by intraoperative transoesophageal echocardiography in a 70-year-old woman undergoing aortic valve replacement. The precise identification of the causative agent was by means of genotypic characterisation with 16S rDNA gene sequencing. The patient was successfully treated with a 6-week course of antibiotics postoperatively, following debridement of the valve vegetation.


Author(s):  
Jogendra Singh ◽  
Dibyasundar Mahanta ◽  
Rudra Pratap Mahapatra ◽  
Debasis Acharya ◽  
Ramachandra Barik

A 57-year-old male presented with recurrent palpitations. He was diagnosed with rheumatic mitral stenosis, right posterior septal accessory pathway and atrial flutter. An electrophysiological study after percutaneous balloon mitral valvotomy showed that the palpitations were due to atrial flutter with right bundle branch aberrancy. The right posterior septal pathway was a bystander because it had higher refractory period than atrioventricular node.


2015 ◽  
Vol 2015 ◽  
pp. 1-9
Author(s):  
Joseph Orme ◽  
Tomas Rivera-Bonilla ◽  
Akil Loli ◽  
Negin N. Blattman

Ralstonia pickettiiis a rare pathogen and even more rare in healthy individuals. Here we report a case ofR. pickettiibacteremia leading to aortic valve abscess and complete heart block. To our knowledge this is the first case report ofRalstoniaspecies causing infective endocarditis with perivalvular abscess.


2019 ◽  
Vol 18 (4) ◽  
pp. 537 ◽  
Author(s):  
Feras A. Alkuwaiti ◽  
Yasser Elghoneimy ◽  
Sami Ghazal

Myxomas originating from the aortic valve are rare. We report a 40-year-old male patient who presented to the King Fahd Hospital of the University, Khobar, Saudi Arabia, in 2017 with a stroke. Transoesophageal echocardiography indicated a mobile mass measuring 6 × 2 mm attached to the right coronary cusp of the aortic valve and a mobile interatrial septum with a small patent foramen ovale (PFO). The patient underwent surgical excision of the mass and direct closure of the PFO. Histopathology confirmed the mass to be a myxoma. Despite their rarity, the recognition and treatment of valvular myxomas is very important; moreover, clinicians should be aware that affected patients may present with an embolic stroke.Keywords: Aortic Valve; Myxoma; Patent Foramen Ovale; Stroke; Transesophageal Echocardiography; Case Report; Saudi Arabia.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Kanksha Peddi ◽  
Alexander L. Hsu ◽  
Tomas H. Ayala

ST-elevation myocardial infarction (STEMI) is a rare and potentially fatal complication of infective endocarditis. We report the ninth case of embolic native aortic valve infective endocarditis causing STEMI and the first case to describe consecutive embolisms leading to infarctions of separate coronary territories. Through examination of this case in the context of the previous eight similar documented cases in the past, we find that infective endocarditis of the aortic valve can and frequently affect more than a single myocardial territory and can occur consecutively. Further, current treatment modalities for embolic infective endocarditis causing acute myocardial infarction are limited and unproven. This index case illustrates the potential severity of complications and the challenges in developing standardized management for such patients.


2021 ◽  
Vol 12 ◽  
Author(s):  
Noriya Enomoto ◽  
Kenji Yagi ◽  
Shunji Matsubara ◽  
Masaaki Uno

Bow hunter's syndrome (BHS) is most commonly caused by compression of the vertebral artery (VA). It has not been known to occur due to an extracranially originated posterior inferior cerebellar artery (PICA), the first case of which we present herein. A 71-year-old man presented with reproducible dizziness on leftward head rotation, indicative of BHS. On radiographic examination, the bilateral VAs merged into the basilar artery, and the left VA was predominant. The right PICA originated extracranially from the right VA at the atlas–axis level and ran vertically into the spinal canal. During the head rotation that induced dizziness, the right PICA was occluded, and a VA stenosis was revealed. Occlusion of the PICA was considered to be the primary cause of the dizziness. The patient underwent surgery to decompress the right PICA and VA via a posterior cervical approach. Following surgery, the patient's dizziness disappeared, and the stenotic change at the right VA and PICA improved. The PICA could be a causative artery for BHS when it originates extracranially at the atlas–axis level, and posterior decompression is an effective way to treat it.


2021 ◽  
Author(s):  
Kamyar Shokraee ◽  
Soroush Moradi ◽  
Tahereh Eftekhari ◽  
Rasoul Shajari ◽  
Maryam Masoumi

Abstract Background: SARS-COV-2, first reported in December 2019, usually presents with respiratory symptoms but can have various other manifestations and sequelae. One of the rare complications of COVID-19 infection is Reactive Arthritis. This complication is more likely to occur following sexually transmitted or gastrointestinal infection.Case presentation: Herein, we report a 58 years old woman hospitalized following COVID-19 infection and was discharged after a week. She consequently presented to the clinic ten days after her discharge, complaining of walking difficulties and radiating pain in her right hip. After ultrasound and MRI, she was diagnosed with reactive arthritis inflammation in the hip’s neck. Other known microorganisms responsible for reactive arthritis were ruled out before attributing it to the earlier COVID-19 infection. She reached remission after being treated using a combination of indomethacin and depot methyl-prednisolone for 14 days. Conclusion: To our knowledge, this is the first case of reactive arthritis caused by SARS-COV-2 in the hip. Further attention should be paid to symptoms occurring after an episode of infection with COVID-19 in order to expand our understanding of the disease and the symptoms with which it can manifest.


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