Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis
A 53-year-old gentleman with a history of a mechanical aortic valve presented to the emergency department complaining of a sudden right-sided abdominal pain. He was found to have atrioventricular dissociation on his initial electrocardiogram and his blood cultures grew Streptococcus viridans. The su...
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Wiley
2015-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2015/471046 |
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| author | Daniel Brancheau George Degheim Christian Machado |
| author_facet | Daniel Brancheau George Degheim Christian Machado |
| author_sort | Daniel Brancheau |
| collection | DOAJ |
| description | A 53-year-old gentleman with a history of a mechanical aortic valve presented to the emergency department complaining of a sudden right-sided abdominal pain. He was found to have atrioventricular dissociation on his initial electrocardiogram and his blood cultures grew Streptococcus viridans. The suspicion for endocarditis with periaortic abscess was high so a transthoracic echocardiogram was performed and showed a mass in the left ventricular outflow tract. For better visualization, a transesophageal echocardiogram was recommended and revealed a bileaflet mechanical aortic valve with perivalvular abscess and valvular vegetation as well as severe eccentric paravalvular aortic regurgitation. After sterilization, the patient underwent a successful surgery. Postoperatively, he remained in complete heart block and a permanent pacemaker placement was performed after complete sterilization. He tolerated the procedure well and was discharged home in a stable condition. Perivalvular abscess is one of the most common cardiac complications of infective endocarditis and is associated with an increased risk of mortality. It is imperative to have appropriate treatment guidelines established. However, because of the relative nature of the disease process and the acuity at which intervention needs to be done, a true assessment of the duration of antibiotic therapy prior to surgical intervention, timing of pacemaker placement, and the type of pacemaker is controversial. |
| format | Article |
| id | doaj-art-7cf5e4519e3b43b9b57db85b14cf49eb |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-7cf5e4519e3b43b9b57db85b14cf49eb2025-02-03T06:14:00ZengWileyCase Reports in Cardiology2090-64042090-64122015-01-01201510.1155/2015/471046471046Timing for Pacing after Acquired Conduction Disease in the Setting of EndocarditisDaniel Brancheau0George Degheim1Christian Machado2Department of Cardiology, Providence Hospital and Medical Centers, 16001 West Nine Mile Road, Southfield, MI 48075, USADepartment of Cardiology, Providence Hospital and Medical Centers, 16001 West Nine Mile Road, Southfield, MI 48075, USADepartment of Cardiology, Providence Hospital and Medical Centers, 16001 West Nine Mile Road, Southfield, MI 48075, USAA 53-year-old gentleman with a history of a mechanical aortic valve presented to the emergency department complaining of a sudden right-sided abdominal pain. He was found to have atrioventricular dissociation on his initial electrocardiogram and his blood cultures grew Streptococcus viridans. The suspicion for endocarditis with periaortic abscess was high so a transthoracic echocardiogram was performed and showed a mass in the left ventricular outflow tract. For better visualization, a transesophageal echocardiogram was recommended and revealed a bileaflet mechanical aortic valve with perivalvular abscess and valvular vegetation as well as severe eccentric paravalvular aortic regurgitation. After sterilization, the patient underwent a successful surgery. Postoperatively, he remained in complete heart block and a permanent pacemaker placement was performed after complete sterilization. He tolerated the procedure well and was discharged home in a stable condition. Perivalvular abscess is one of the most common cardiac complications of infective endocarditis and is associated with an increased risk of mortality. It is imperative to have appropriate treatment guidelines established. However, because of the relative nature of the disease process and the acuity at which intervention needs to be done, a true assessment of the duration of antibiotic therapy prior to surgical intervention, timing of pacemaker placement, and the type of pacemaker is controversial.http://dx.doi.org/10.1155/2015/471046 |
| spellingShingle | Daniel Brancheau George Degheim Christian Machado Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis Case Reports in Cardiology |
| title | Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis |
| title_full | Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis |
| title_fullStr | Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis |
| title_full_unstemmed | Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis |
| title_short | Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis |
| title_sort | timing for pacing after acquired conduction disease in the setting of endocarditis |
| url | http://dx.doi.org/10.1155/2015/471046 |
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