A Case: Infective Endocarditis of a Prosthetic Mitral Valve Transesophageal Echocardiography

A cardiology case ( Images are courtesy of Dr Abdallah Almaghraby) Infective endocarditis of a prosthetic mitral valve Transesophageal echocardiography. This is a case of a 32 year old female with a history of mitral valve replacement with a bileaflet mechanical valve before 3 years, presenting with fever and a cerebrovascular stroke.
A Vegetation in echocardiography appears as an irregularly shaped, discrete echogenic mass which is adherent to, but distinct from the endocardial surface or an intracardiac device. Oscillation of the mass is supportive for the diagnosis, but not mandatory.
Infective endocarditis (IE) is a microbial infection of the endocardium or implanted intracardiac materials (e.g., prosthetic valves, conduits), or pacing electrodes, and indwelling catheters. The most typical pathologic feature of IE is a mobile vegetation associated with valve leaflets. Vegetations are composed of fibrin, platelets, debris, and bacteria. Left-sided lesions are more common than right-sided lesions (the latter are common in intravenous drug use and congenital abnormalities). The insidence of IE in the general population is approximately 3-4 cases in 100.000 people per year.
Conditions that predispose to the development of IE by order of frequency include degenerative valve disease , presence of a prosthetic heart valve, intravenous narcotic drug use, rheumatic heart disease and congenital heart disease.