Right ventricular mural endocarditis: description of a case

Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
Maria Cristina BaratellaDaniele D'Este

Abstract

We report the case of a 45-year-old man addicted to intravenous drug abuse who was admitted to our hospital for dyspnea, fever and chest pain. Chest X-ray showed diffuse right lung opacity and pleural effusion. Transthoracic echocardiography and contrast-enhanced cardiac magnetic resonance imaging revealed a plurilobated, highly mobile mass in the right ventricle originating from the moderator band near the apical trabeculae. Cardiac structure and valves were normal. Blood cultures were positive for Staphylococcus hominis. The diagnosis of infective endocarditis with mural vegetation was made. Specific antibiotic therapy was started with success and after 3 weeks the mass disappeared. Infective endocarditis with mural vegetation in the absence of valvular lesions is uncommon. Differential diagnosis is always required, but clinical course should be our guide in decision making.

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