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Case Reports
. 2017 Mar;9(3):225-228.
doi: 10.14740/jocmr2903w. Epub 2017 Jan 25.

Septic Shock of Unknown Origin: A Case Report of a Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa

Julio Gil  1 , Hugo Antunes  1 , Bruno Marmelo  1 , Luis Abreu  1 , Maria Luisa Goncalves  1 , Luis Ferreira Dos Santos  1 , Jose Costa Cabral  1
Affiliations
Case Reports

Septic Shock of Unknown Origin: A Case Report of a Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa

Julio Gil et al. J Clin Med Res. 2017 Mar.

Abstract

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare complication of infective endocarditis and trauma, particularly of aortic valve surgery. Clinical symptoms are usually unspecific and generally due to complications. Transesophageal echocardiography (TEE) is the most commonly used exam to diagnose P-MAIVF. The main echocardiographic feature is the presence of a cavity communicating with the left ventricular outflow tract that expands during systole and collapses during diastole. Most frequent complications are formation of a fistulous tract and compression of adjacent structures. Surgical correction is usually the treatment of choice. The authors describe a case of a female patient with a septic shock of unclear origin. After antibiotic therapy and organ-supporting measures without apparent improvements, a TEE revealed infective endocarditis, complicated with P-MAIVF. Despite adequate treatment, the patient did not survive for long enough to be submitted to surgical repair.

Keywords: Infective endocarditis; Mitral-aortic intervalvular fibrosa; Pseudoaneurysm.

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Transesophageal echocardiography.
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