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Destructive bacterial endocarditis of critically stenotic aortic valve with transformation to florid aortic regurgitation with massive abscess presenting without septic symptoms
  1. Dale Murdoch1,2,
  2. Rohan Jayasinghe1,3,
  3. Vivek Kulkarni1
  1. 1Cardiology Department, Gold Coast Hospital, Southport, Queensland, Australia
  2. 2The University of Queensland, School of Medicine, Brisbane, Queensland, Australia
  3. 3Griffith University, School of Medicine, Southport, Queensland, Australia
  1. Correspondence to Dr Dale Murdoch, Department of Cardiology, The Gold Coast Hospital, 108 Nerang St, Southport, Queensland 4215, Australia;

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A 74-year-old woman with known critical aortic stenosis presents to hospital with acute, severe dyspnoea.

The patient had presented 3 months earlier with dyspnoea on exertion. Critical calcific aortic stenosis was diagnosed on echocardiography with an aortic valve area of 0.44 cm2 and mean pressure gradient of 54 mm Hg (figure 1A). She was referred to a cardiac surgeon for aortic valve replacement, but was initially managed conservatively.

Figure 1

(A) Previous transthoracic echocardiogram demonstrating severe aortic stenosis. Presenting chest …

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