Document Type : Case Report

Authors

Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Hasanuddin, Makassar, South Sulawes, Indonesia.

Abstract

Infective endocarditis (IE) involving both the aortic and pulmonary valves is uncommon. A young man presented to our department with fatigue, chest pain, and intermittent fevers. His echocardiogram showed multiple large vegetation pieces in the aortic and pulmonary valves, a perimembranous ventricular septal defect (VSD) with a left-to-right shunt, and a double-chamber right ventricle (DCRV). After 3 weeks of antibiotic therapy, surgery was indicated since there was no change in the vegetation size and high risk of embolism. Postoperative echocardiography showed post-repair DCRV with insignificant residual obstruction in mid-RV, no residual VSD shunt, and no residual vegetation. Multiple valvular involvement in IE is rare and is associated with a more complicated clinical course and a higher risk of complications. In this case, perimembranous VSD is a known predisposing factor for IE in the aortic valve, while DCRV is associated with IE development in the pulmonary valve. This case report also emphasizes the importance of early diagnosis, timely antibiotic treatment, and surgery in complicated cases. (Iranian Heart Journal 2024; 25(1): 106-111)

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