Native Valve Infective Endocarditis Associated with Ruptured Right Sinus of Valsalva: A Case Report
Authors:   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Aranda Marcos García , Calixto Estanislao Antonio ,   epartment of Clinical Cardiology. National Institute of Cardiology "Ignacio Chávez", Mexico City, Mexico, García Josué Isaac Olarte ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Meza Karla Ruth Galindo ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Mayorquín Tania Dennise Gómez ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, la Cruz Alfredo Bautista de ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Perez Cruz Ana Gabriela ,   Department of Clinical Cardiology. IMSS UMAE Specialty Hospital 14 National Medical Center ¨Adolfo Ruiz Cortines¨, Veracruz, Mexico, Sosa Yunelly Paola Sarmiento ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Villalobos Rolando Castellanos ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Ibarra Moisés Rodríguez ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Aranda Héctor García ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Gutiérrez Susana Patricia Díaz ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Navarrete Jessica Ariatna Carreto ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Herrera Nestor Alonso Cerino ,   Department of Internal Medicine. High Specialty Regional Hospital of Veracruz SESVER, Mexico, Hernández Julia Inés Obregón ,   Department of Clinical Cardiology. IMSS UMAE Specialty Hospital 14 National Medical Center ¨Adolfo Ruiz Cortines¨, Veracruz, Mexico
Published: August 2023

Endocarditis is defined as an infection of the cardiac endothelium. The incidence occurs from 2 to 10 cases per 100,000 people/year. Cardiovascular complications, including cardiac arrest, cardiogenic shock, myocardial infarction, acute heart failure, and heart block. The case of a 51-year-old male patient with fever, asthenia, adynamia, and chills is presented, evolving to shock data to determine the origin, requiring management with vasopressor, a diagnostic protocol with transthoracic echocardiogram is performed where calcified aortic valve and mass attached to the valve ring and image suggestive of abscess at the level of the sinuses of Valsalva are observed. Transesophageal echocardiogram, in addition to the vegetation previously described and the abscess in the mitro-aortic continuity, tricuspid valve lesion with rupture of the sinus of Valsalva. Consultation was requested for cardiothoracic surgery with aortic valve replacement due to a N23 mechanical valve, with closure of the right sinus of Valsalva ruptured to the right ventricle infective endocarditis of the aortic and tricuspid valve with clinical improvement if any eventualities occurred. Rupture of the sinus of Valsalva with fistulization towards lower-pressure cavities (generally the right atrium and ventricle) is probably the most frequent form of presentation. Accurate diagnosis of complicated infective endocarditis means the difference between a good evolution and a poor prognosis.