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Cardiology, Salisbury NHS Foundation Trust, Salisbury, Wiltshire, UK.
Published: September 2021
AI Article Synopsis
Infective endocarditis is a serious heart infection that can be very dangerous, with a risk of death around 20%.
A 60-year-old woman who had heart problems fell and had stomach pain, leading to surgery where doctors found her spleen was ruptured.
Later, doctors discovered she had a large infection on her heart valve, probably causing the spleen issue, and she needed medicine and more heart surgery.
Article Abstract
Infective endocarditis remains a dangerous condition and carries a mortality risk of approximately 20%. Splenic rupture is a rare complication of endocarditis. A 60-year-old woman with a history of atrial fibrillation, mitral valve repair and severe mitral regurgitation was admitted with a fall and abdominal pain. Emergency laparotomy was performed leading to a diagnosis of splenic rupture, for which splenectomy was performed. Four months later, the patient represented with symptoms of a transient ischaemic attack. Transthoracic and transoesophageal echocardiogram confirmed a large vegetation on the anterior mitral valve leaflet. Treatment with antibiotics and re-do mitral valve surgery was performed. The cause of the initial splenic rupture was felt to have been secondary to undiagnosed infective endocarditis. It is imperative to consider endocarditis in a case of spontaneous splenic rupture particularly in high-risk patients such as those with previous valve surgery.
