A young woman having undergone surgery for aortic coarctation in childhood developed severe cardiac insufficiency after being ill for a few months. The clinical picture turned out to be compatible with subacute endocarditis. The patient received antibiotic treatment with vague effect on hemodynamics and the aortic valve was replaced. However, after valvular replacement a refractory myocardial insufficiency developed. A heart transplantation was performed. Thereafter the patient has been well.

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