Tricuspid and pulmonary valve endocarditis associated with double-chambered right ventricle

Article information

Kosin Med J. 2015;30(1):81-85

Publication date (electronic) : 2015 January 20

doi : https://doi.org/10.7180/kmj.2015.30.1.81

Jin Cheol Myeong ¹^,, Jung Yeon Chin ¹, Jin Ho Choi ², Young Min Rah ¹, Jun Hyung Park ¹

¹Department of Cardiology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea

²Department of Cardiovascular surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea

Corresponding Author：Jin Cheol Myeong, Division of Cardiology, Eulji University Hospital, 95, Dunsan-Seoro, Seo-gu, Daejeon 302-120, Korea TEL: +82-10-9976-9992 FAX: +82-42-611-3183 Email: spyman2000@naver.com

Received 2014 September 18; 2014 October 08; Accepted 2014 October 15.

Abstract

We report a rare case of tricuspid valve and pulmonary valve endocarditis associated with a double-chambered right ventricle in an adult female with pulmonary artery aneurysm and septic pulmonary embolism by Streptococcus mitis. She was treated with aggressive antibiotic therapy followed by debridement of the infective lesion of tricuspid valve, pulmonary valve replacement using xenograft and resection of obstructing muscular bundles in right ventricle.

Keywords: Bacterial endocarditis; Congenital heart disease; Pulmonary valve; Right ventricle; Tricuspid valve

Figure 1.

Initial electrocardiogram showing right ventricular hypertrophy with strain pattern, right axis deviation, and right atrial enlargement.

Figure 2.

Pulmonary angio CT showing mild cardiomegaly with right heart enlargement and multiple distal pulmonary infarction (white arrow heads) with multiple pulmonary artery aneurysm (white arrows).

Figure 3.

Transthoracic echocardiogram showing (A) continuous-wave Doppler tracing along the right ventricular outflow tract with peak gradient of 87 mmHg across the subinfundibulum (B) hypertrophied muscular bands dividing the right ventricle (white arrow) with D-shaped interventricular septum and large vegetation on pulmonary valve. LV: left ventricle, PV: pulmonary valve, RV: right ventricle.

Figure 4.

Transesophageal echocardiogram showing echogenic shaggy materials (white arrow) on hypertrophied muscular bands, suspicious vegetations.

References

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