Journal of Cardiothoracic and Vascular Anesthesia 32 (2018) 1087–1089 Contents lists available at ScienceDirect Journal of Cardiothoracic and Vascular Anesthesia journal homepage: www.jcvaonline.com Diagnostic Dilemma Unusual Echolucency Seen After Bacterial Endocarditis Morgan Marino, MD, Christoforos Frangopoulos, Priya A. Kumar, MD, Meena Bhatia, MD Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, NC Key Words: Bacterial endocarditis; arteriovenous ﬁstula; coronary sinus; right coronary artery A 52-YEAR-OLD, 169-cm, 99-kg man presented to the authors’ institution with dyspnea on exertion and progressive exercise intolerance. Three months before presentation, he was diagnosed with aortic valve endocarditis. The bacteria were identiﬁed as Viridans streptococci, and the patient underwent 6 weeks of antibiotic treatment, with resolution of his symptoms. The patient subsequently developed atrial ﬁbrilla- tion, and transthoracic echocardiography demonstrated a dilated right atrium, an ejection fraction of 45% to 50%, and Fig 2. Midesophageal 2-chamber transesophageal echocardiographic image with color Doppler showing turbulent ﬂow in the coronary sinus. Fig 1. A midesophageal 2-chamber transesophageal echocardiographic image showing enlarged coronary sinus. Address reprint requests to Meena Bhatia, MD, Department of Anesthe- siology, University of North Carolina School of Medicine, N2198 UNC Fig 3. Three-dimensional image obtained by advancing the probe from
Journal of Cardiothoracic and Vascular Anesthesia – Elsevier
Published: Apr 1, 2018
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