MitraClip-Associated Endocarditis: Emergency Department Diagnosis With Point of Care Ultrasound.

Autor: Rempfer E; West Virginia University School of Medicine, Morgantown, West Virginia., Basinger H; West Virginia University School of Medicine, Morgantown, West Virginia., Stawovy L; Department of Internal Medicine, West Virginia University, Morgantown, West Virginia., End B; Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia., Shockcor W; Department of Internal Medicine, West Virginia University, Morgantown, West Virginia., Minardi J; Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia.
Jazyk: angličtina
Zdroj: The Journal of emergency medicine [J Emerg Med] 2020 Jun; Vol. 58 (6), pp. 942-946. Date of Electronic Publication: 2020 Apr 01.
DOI: 10.1016/j.jemermed.2020.02.016
Abstrakt: Background: Management of mitral valve regurgitation in patients with multiple comorbidities is complicated because of poor surgical candidacy. Less invasive techniques for these patients include the MitraClip device, an endovascular repair option used to reduce mitral valve regurgitation symptoms. However, complications include leaflet damage, stenosis, and infectious endocarditis.
Case Report: Four years after MitraClip placement, an 80-year-old man presented to the emergency department with progressive dyspnea. He was diagnosed with MitraClip-associated infectious endocarditis by the emergency physician using point-of-care ultrasound. There are 6 reported cases of infective endocarditis in patients with MitraClip devices, with this being the first case identified using point-of-care ultrasound. This is also the first reported case of MitraClip-associated Corynebacterium endocarditis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The use of the MitraClip device and its echocardiographic appearance is not widely described in the published emergency medicine literature. Knowledge of this device, its appearance, and the potential complications is essential for emergency physicians caring for these patients. Rapid diagnosis may lead to earlier initiation of treatment and optimal disposition for these complex patients.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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