University of British Columbia, Vancouver.
Can J Cardiol. 2010 Aug-Sep;26(7):e280-1. doi: 10.1016/s0828-282x(10)70427-x.
A 51-year-old woman with a peritoneovenous shunt for refractory ascites presented with three months of increasing fatigue, exertional dyspnea, night sweats and positive blood cultures. Imaging revealed multiple pulmonary emboli. Transthoracic chocardiography demonstrated moderate tricuspid regurgitation and a large pedunculated right atrial mass attached to the interatrial septum. The echocardiographic appearance remained unchanged after one month of antibiotic therapy and nticoagulation. Intraoperatively, the mass was easily excised and the grossly abnormal tricuspid valve replaced. Pathology revealed endocarditis with multiple bacterial colonies, and fibromyxoid changes consistent with postinflammatory valve disease.
一位 51 岁的女性因难治性腹水行腹膜静脉分流术，现出现三个月的进行性疲劳、劳力性呼吸困难、夜间盗汗和阳性血培养。影像学显示多发肺栓塞。经胸超声心动图显示中度三尖瓣反流和一个大的带蒂右心房肿块附着于房间隔。抗生素治疗和抗凝治疗一个月后，超声心动图表现无变化。术中，肿块很容易被切除，明显异常的三尖瓣被替换。病理显示赘生物性心内膜炎，伴有多个细菌菌落和纤维粘液样改变，符合炎症后瓣膜病。
