Shimbo Mai, Watanabe Hiroyuki, Abe Tatsumi, Sato Teruki, Koyama Takashi, Yamamoto Hiroshi, Ito Hiroshi
Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Japan.
Intern Med. 2015;54(19):2463-5. doi: 10.2169/internalmedicine.54.4233. Epub 2015 Oct 1.
Infective endocarditis (IE) associated with atrial septal defect (ASD) is extremely rare. However, tricuspid regurgitation (TR) secondary to right ventricular overload is a potential cause of IE, and once it occurs, the development of a paradoxical embolism may lead to fatal complications. We herein report the case of a 50-year-old woman who was admitted due to a persistent fever resistant to antibiotics. Echocardiography showed secundum ASD, moderate TR and a mobile vegetation measuring 15×10 mm attached to the tricuspid valve. Given the risk of developing a paradoxical embolism, urgent surgery was successfully performed.
与房间隔缺损（ASD）相关的感染性心内膜炎（IE）极为罕见。然而，继发于右心室负荷过重的三尖瓣反流（TR）是IE的一个潜在病因，一旦发生，反常栓塞的发展可能导致致命并发症。我们在此报告一例50岁女性患者，因对抗生素治疗无效的持续发热入院。超声心动图显示继发孔型ASD、中度TR以及一个附着于三尖瓣的大小为15×10 mm的活动赘生物。鉴于存在发生反常栓塞的风险，成功实施了紧急手术。
