Double-Chambered Right Ventricle Presenting in Adulthood With Aortic and Pulmonic Valve Endocarditis

Abstract

A 55-year-old woman admitted with symptoms of right heart failure received a diagnosis of double-chambered right ventricle and a ventricular septal defect with aortic and pulmonic valve endocarditis. This case highlights the use of multimodality imaging and importance of adult congenital heart disease expertise in the diagnosis and treatment of such patients. (Level of Difficulty: Intermediate.).

Keywords: congenital heart defect; endocarditis; imaging; ventricular septal defect.

Graphical abstract

Figure 1

Multimodality Imaging of Double-Chambered Right Ventricle and Endocarditis (A) Chest x-ray showing cardiomegaly with right-sided aortic arch (red arrow), pulmonary edema and small right pleural effusion. (B, C) Color transesophageal echocardiogram comparison images show proximal right ventricle high-pressure chamber with hypertrophy (red arrow) and subvalvular muscular obstruction (blue arrow) with color Doppler of high gradient (white arrow) and distal low-pressure chamber (green arrow). (D) Transesophageal echocardiogram shows aortic valve vegetation (green arrow) and pulmonic valve vegetation extending into pulmonary artery (red arrow). (E) Cardiac magnetic resonance shows hypertrophied proximal right ventricle chamber (red arrow) with subinfundibular obstruction (blue arrow) and distal low-pressure chamber (green arrow).