The Infectious Tale of Aerococcal Aortic Endocarditis: Cardiac Pacing in Acute Aortic Insufficiency With Complete Heart Block as a Bridge to Aortic Valve Replacement
Autor: | Fouad Jabbour, Kartikeya Kashyap, Vinh Nguyen, Victor Farah, Laura Bradel, Pietro Bajona |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Aortic valve
medicine.medical_specialty Heart block Cardiology complete heart block Transesophageal echocardiogram Aortic valve replacement Internal medicine gated coronary computed tomography medicine Internal Medicine Endocarditis aortic valve abscess biology medicine.diagnostic_test business.industry aerococcus infective endocarditis cardiac pacing General Engineering medicine.disease biology.organism_classification aortic insufficiency medicine.anatomical_structure Blood pressure Cardiac/Thoracic/Vascular Surgery cardiovascular system surgical aortic valve replacement (savr) Aerococcus urinae Transthoracic echocardiogram business |
Zdroj: | Cureus |
ISSN: | 2168-8184 |
Popis: | Here, we describe a rare case of Aerococcus endocarditis causing aortic insufficiency and paravalvular abscess presenting as complete heart block and shock. A 76-year-old man with diabetes mellitus presented to the emergency department with fever and dyspnea. His temperature was 102.4°F, heart rate 59 beats per minute, blood pressure 105/44 mmHg, and oxygen saturation was 98% on 6L oxygen. Examination revealed bounding carotid pulses, a 2/6 early blowing diastolic murmur at the left lower sternal border, and diminished lung sounds at the bases. Laboratory data showed leukocytosis of 19.65 k/µL, blood urea nitrogen 72 mg/dL, creatinine 2.92 mg/dL, lactic acid 3.1 mmol/L, pro-B-type natriuretic peptide 15,342 pg/mL, high-sensitivity troponin 136 ng/L, aspartate aminotransferase 129 U/L, and alanine aminotransferase of 115 U/L. An electrocardiogram showed complete heart block, and a transvenous pacemaker was placed. A transesophageal echocardiogram revealed an aortic root abscess and severe aortic insufficiency secondary to Aerococcus urinae. Ventricular pacing was used to decrease aortic insufficiency and optimize computed tomography with gating to view the coronary arteries due to wall motion abnormalities seen on the transthoracic echocardiogram. His aortic valve was replaced, and a pacemaker was planned. Aortic valve Aerococcus endocarditis is rare and can lead to complete heart block and aortic insufficiency. Cardiac pacing improves hemodynamics by increasing heart rate and decreasing left ventricular end-diastolic pressure. |
Databáze: | OpenAIRE |
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