Mural endocarditis - by default

  • A. Patel University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
  • D. Kakooza University of the Witwatersrand
  • T. Kalk University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
  • N. Tsabedze University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital

Abstract

We report on a case of a 33-year-old female patient with known adult congenital heart disease in the form of a coronary cameral fistula who, on prior presentation, had refused treatment and subsequently defaulted follow-up, but unfortunately developed a serious and rare complication. She presented with non-specific neurological symptoms of transient visual loss and headaches. Clinical examination revealed aortic regurgitation with peripheral features of infective endocarditis. This was confirmed with transthoracic echocardiogram, but additionally, we found mural endocarditis of the right atrial posterior wall. An initial CT brain scan and ophthalmology assessments were negative, blood cultures were positive and confirmed infective endocarditis, and she was referred for urgent cardiothoracic surgery. Unfortunately, she had further complications with a large intracranial haemorrhage which ultimately led to her death. This case illustrates a rare entity with disastrous complications.

Author Biographies

A. Patel, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
D. Kakooza, University of the Witwatersrand
Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
T. Kalk, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
N. Tsabedze, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital
Published
2021-07-29
Section
Image in Cardiology