Wang K, Gobel F L, Gleason D F
Am Heart J. 1975 Mar;89(3):359-65. doi: 10.1016/0002-8703(75)90086-1.
Bacterial endocarditis complicating idiopathic hypertrophic subaortic stenosis (IHSS) is uncommon but endocarditis may be the first clinical manifestation of IHSS. In this report of such a case, the aortic and the mitral valves were the sites of the bacterial infection. Many chordae tendineae to the mitral valve were ruptured from the extension of the infectious process. The endothelial lesions, which served as the seat for the bacterial infection on the anterior mitral leaflet, likely resulted from its abutting action against the septal prominence. Damage to the aortic valve leaflet may have resulted from abnormal valve motion caused by IHSS and created an environment conducive to endocarditis. This patient developed aortic insufficiency during the course of bacterial endocarditis, suggesting that the occasional association of aortic insufficiency in patients with IHSS may be secondary to healed endocarditis of the aortic valve.
细菌性心内膜炎并发特发性肥厚性主动脉瓣下狭窄（IHSS）并不常见，但心内膜炎可能是IHSS的首发临床表现。在本病例报告中，主动脉瓣和二尖瓣是细菌感染的部位。二尖瓣的许多腱索因感染过程的蔓延而断裂。二尖瓣前叶上作为细菌感染部位的内皮病变，可能是由于其与室间隔隆起的邻接作用所致。主动脉瓣叶的损伤可能是由IHSS引起的瓣膜异常运动导致的，并创造了有利于心内膜炎发生的环境。该患者在细菌性心内膜炎病程中出现了主动脉瓣关闭不全，提示IHSS患者偶尔出现的主动脉瓣关闭不全可能继发于主动脉瓣心内膜炎愈合后。
