A 24-year-old man with systemic lupus erythematosus and antiphospholipid syndrome complicated by lupus nephritis presented with acute limb ischaemia secondary to an embolus. Following embolectomy, the patient underwent a transthoracic echocardiogram which revealed a large vegetation on all three cusps of the aortic valve. The patient was taken for an urgent aortic valve replacement with a mecha...

Native aortic valve thrombosis in primary antiphospholipid syndrome (APLS) is a rare entity. We describe a 38-year-old man who presented with neurological symptoms and a cardiac murmur. Transthoracic echocardiography detected a large bicuspid aortic valve thrombus. Laboratory evaluation showed the presence of antiphospholipid antibodies. Anticoagulation was started, and serial echocardiographic...

M ore and more patients are operated on during the active phase of infective endocarditis (IE). Between 1991 and 1999, in France, the rate of cardiac surgery has increased from 31% to 50%. This may, at least in part, explain the concomitant decrease of in hospital mortality, from 22% to 17%. Nonetheless, the indications for cardiac surgery and its optimal timing remain difficult decisions. The ...

Several large series of cases of infective endocarditis have mentioned the paucity of pulmonic valve involvement. 1-3 A recent study by Hubbell et a14 found no cases of pulmonic valve endocarditis in a group of 79 drug addicts with 97 separate episodes of infective endocarditis. It is possible that the paucity of such reports may be due in part to the difficulty of assessing the pulmonic valve....

Echocardiography is the mainstay imaging technique for detecting infective endocarditis vegetations but may struggle to detect and characterise complicating features. There is increasing interest in the use of multidetector computed tomography (MDCT) as an adjunct to echocardiography, especially where there is concern for abscess or pseudoaneurysm formation. We present the case of a 70-year-old...

A ruptured sinus of Valsalva aneurysm rarely accompanies the aortic and tricuspid valve endocarditis. A 36-year-old woman presented with low-threshold dyspnea on exertion and fever. Transthoracic and transesophageal echocardiography showed a ruptured noncoronary sinus of Valsalva aneurysm with large vegetations on the tricuspid and aortic valves, resulting in moderately severe tricuspid regurgi...

PURPOSE We aimed to evaluate the utility of cardiac magnetic resonance imaging (MRI) for the diagnosis of infective endocarditis (IE). METHODS Sixteen patients with a preliminary diagnosis of IE (10 women and six men; age range, 4-66 years) were referred for cardiac MRI. MRI sequences were as follows: echo-planar cine true fast imaging with steady-state precession (true-FISP), dark-blood fast...

Like most controversial topics in medicine, the truth probably lies between the two schools of thought. In the early acute Case-roughly within the first 48 hours-operation is indeed quite simple and there is no contraindication to its performance in an otherwise fit patient provided a skilled surgeon is available and that there are full facilities for operative cholangiography. Surgery is also ...