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CASE REPORT
Year : 2019  |  Volume : 29  |  Issue : 4  |  Page : 183-184

A systolic murmur late after infective endocarditis: Looking for the guilty


1 Unit of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples, Italy
2 Unit of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples; Unit of Cardiology and Intensive Coronary Care, “Umberto I” Hospital, Nocera Inferiore, Salerno, Italy

Correspondence Address:
Giancarlo Scognamiglio
Unit of Cardiology, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcecho.jcecho_59_19

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Aortic location of infective endocarditis is a risk factor for perivalvular extension of infection, even when a native valve is involved. We report the case of a 50-year-old man with a systolic murmur and a history of previous aortic valve infective endocarditis requiring cardiac surgery. A thorough echocardiographic assessment, including three-dimensional transesophageal echocardiography, clearly demonstrated the presence of two distinct postinfective complications, i.e., a fistula of the mitral-aortic intervalvular curtain communicating in systole with the left atrium and an acquired Gerbode-type ventricular septal defect. Our case highlights the pivotal role of echocardiography for a correct and comprehensive diagnostic assessment in the complex scenarios frequently encountered after infective endocarditis.


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