Chronic Hypertensive Patient with Atrial Fibrillation had Refractory Dyspnea  and Fever, Mitral Valvular Vegetations were culprit.

Dr. Naresh Sen; Dr. Sonal Tanwar

Volume : V, Issue : IV, April - 2016

Chronic Hypertensive Patient with Atrial Fibrillation had Refractory Dyspnea and Fever, Mitral Valvular Vegetations were culprit.

Dr. Naresh Sen, Dr. Sonal Tanwar

Abstract :

A 65–year–old man was reffered to our Cardiology Department with refractory dyspnea and fever. He had a long history of hypertension and chronic atrial fiillation. 2D Echocardiography showed a large and mobile mitral valve vegetation, prolapsing into the left ventricular inflow tract with mitral regurgitation . Mitral regurgitation was hemodynamically significant and a moderate–to–severe pulmonary hypertension was observed.Tissue Doppler Imaging recorded at the level of the vegetation detected its incoherent motion and measured the peak antegrade velocity. Blood cultures were negative for both aerobic and anaerobic microbes. Diagnosis of fungal endocarditis was made and a treatment with fluconazole was started. In our patient echocardiography played a key role for a better definition of the clinical course. In this context, Tissue Doppler Imaging might provide an adjunctive parameter for the prediction of embolic risk from endocardial vegetations: the peak antegrade velocity recorded at the level of the vegetation.