Hioki J, Shibutani T, Naito T, Uehara H, Sasaki T, Hirano Y, Ikawa H, Miyazaki T, Ishikawa K, Katori R
First Department of Internal Medicine, Kinki University School of Medicine, Osaka.
J Cardiol. 1997;29 Suppl 2:143-9.
A 58-year-old man was involved in an automobile accident and suffered remittent fever, leukocytosis and high C-reactive protein level. He developed a diastolic murmur 2 months after the accident. Transesophageal echocardiography showed severe aortic regurgitation with a vegetation-like echo image attached to the right coronary cusp leaflet, suggesting infective endocarditis. Intensive medical treatment for 11 months did not improve the vegetation-like echo-image, so aortic valve replacement was performed. Disruption of the right coronary cusp leaflet was confirmed surgically. Prolapse had occurred as a result of disruption during diastole. The vegetation-like echo-image was considered to be the tip of this leaflet.
