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Case Reports
. 2019 Jul 15;32(3):387-389.
doi: 10.1080/08998280.2019.1617011. eCollection 2019 Jul.

Mitral stenosis produced by infective endocarditis involving a previously anatomically normal valve

Charles S Roberts  1 , Gregory P Milligan  2 , Robert C Stoler  2 , Paul A Grayburn  2 , William C Roberts  2
Affiliations
Case Reports

Mitral stenosis produced by infective endocarditis involving a previously anatomically normal valve

Charles S Roberts et al. Proc (Bayl Univ Med Cent). .

Abstract

Described herein is a 63-year-old man who developed methicillin-sensitive Staphylococcus aureus endocarditis on a previously anatomically normal mitral valve. The resulting vegetations were so large that severe mitral stenosis resulted. The development of valve stenosis due exclusively to infective endocarditis is extremely rare.

Keywords: Cerebral emboli; infective endocarditis; mitral stenosis; mitral valve replacement.

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Figures

Figure 1.
Figure 1.
Four-chamber views from (a) initial study and (b) 1 month later. Mitral annular calcium (arrows) is present on the initial study, with no evidence of endocarditis. A large vegetation (large arrow) is seen 1 month later. (c) Continuous wave Doppler of mitral inflow showing a mean gradient of 6 mm Hg on initial study, (d) which increased to 14 mm Hg due to obstruction from the large vegetation.
Figure 2.
Figure 2.
Photographs of the entire operatively excised mitral valve (top) and close-up of the vegetation obstructing the mitral orifice. Scattered microorganisms, foci of polymorphonuclear and mononuclear cells, large collections of fibrin, and a few small calcific fragments were present histologically in the large vegetation.
See this image and copyright information in PMC

References

    1. Arnett EA, Roberts WC. Active infective endocarditis: a clinicopathologic analysis of 137 necropsy patients. Curr Probl Cardiol. 1976;1(7):1–75. doi:10.1016/0146-2806(76)90003-7. - DOI - PubMed
    1. Roberts WC, Oluwole BO, Fernicola DJ. Comparison of active infective endocarditis involving a previously stenotic versus a previously nonstenotic aortic valve. Am J Cardiol. 1993;71(12):1082–1088. doi:10.1016/0002-9149(93)90577-Y. - DOI - PubMed
    1. Fernicola DJ, Roberts WC. Clinicopathologic features of active infective endocarditis isolated to the mitral valve. Am J Cardiol. 1993;71(13):1186–1197. doi:10.1016/0002-9149(93)90644-R. - DOI - PubMed
    1. Roberts WC, Ewy GA, Glancy DL, Marcus FI. Valvular stenosis produced by active infective endocarditis. Circulation. 1967;36(3):449–451. doi:10.1161/01.CIR.36.3.449. - DOI - PubMed
    1. Sach PV, Laker JB, Barlow JB. Severe aortic stenosis produced by bacterial endocarditis. BMJ. 1969;3:97–98. doi:10.1136/bmj.3.5662.97. - DOI - PMC - PubMed

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