Pereira Sara Couto, Antonio Pedro Silverio, Rigueira Joana, Almeida Ana G
Cardiology Division, Heart and Vessels Department, Centro Hospitalar Universitário de Lisboa Norte, E.P.E., Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal.
Cardiovascular Centre of the University of Lisbon (CCUL), CAML, Lisbon School of Medicine, University of Lisbon, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal.
Eur Heart J Case Rep. 2023 Jun 28;7(7):ytad286. doi: 10.1093/ehjcr/ytad286. eCollection 2023 Jul.
Infective endocarditis is a rare but serious disease with high morbidity and mortality due to its potential life-threatening complications. Gerbode defect is an anomalous connection between the left ventricle and the right atrium that can be either congenital or acquired, with previous rare reports following abscess formation in infective endocarditis.
A 27-year-old woman presented in hospital with Janeway lesions, stroke, splenic and hepatic abscesses, and transient complete auriculoventricular block. Bicuspid aortic valve infective endocarditis to methicillin-sensitive and acquired Gerbode defect were diagnosed. After intravenous antibiotics and aortic valve replacement, the patient was discharged without sequelae.
Bicuspid aortic valve patients have a higher risk of infective endocarditis than the general population. Infective endocarditis may present with multiple complications, including systemic embolization and local perivalvular lesions. Acquired Gerbode defect is a rare complication of infective endocarditis where transoesophageal echocardiography plays an important role for small shunt detection before surgical intervention.
感染性心内膜炎是一种罕见但严重的疾病,因其潜在的危及生命的并发症而具有高发病率和死亡率。Gerbode缺损是左心室与右心房之间的异常连接,可为先天性或后天性,既往有感染性心内膜炎脓肿形成后罕见的报道。
一名27岁女性因Janeway损害、中风、脾脓肿和肝脓肿以及短暂性完全房室传导阻滞入院。诊断为对甲氧西林敏感的二叶式主动脉瓣感染性心内膜炎并获得性Gerbode缺损。经静脉抗生素治疗和主动脉瓣置换术后,患者无后遗症出院。
二叶式主动脉瓣患者发生感染性心内膜炎的风险高于普通人群。感染性心内膜炎可能出现多种并发症,包括全身栓塞和局部瓣周病变。获得性Gerbode缺损是感染性心内膜炎的一种罕见并发症,经食管超声心动图在手术干预前检测小分流方面发挥重要作用。