高橋 伸基, 吉田 清, 穂積 健之, 赤阪 隆史, 高木 力, 加地 修一郎, 米澤 嘉啓, 盛岡 茂文

Nobuki TAKAHASHI, Kiyoshi YOSHIDA, Takeshi HOZUMI, Takashi AKASAKA, Tsutomu TAKAGI, Syuichiro KAJI, Yoshihiro YONEZAWA, Shigefumi MORIOKA

神戸市立中央市民病院循環器センター内科

Division of Cardiology, Kobe General Hospital

キーワード : Infective endocarditis, Mitral valve aneurysm, Mitral valve perforation, Transesophageal echocardiography

A 35-year-old man with aortic regurgitation was admitted to this institution with fever and dyspnea on effort. Although vegetations were not readily apparent on transthoracic echocardiographic examination at time of admission, transesophageal echocardiography showed vegetations on the aortic and mitral valves. A diagnosis of infective endocarditis was made when α-hemolytic streptococci were found in the blood culture. Antibiotic therapy was started, but transesophageal echocardiography showed perforation of the mitral valve on the fifth day after admission. The part of the mitral valve surrounding the perforation gradually bulged into the left atrium, and mitral- and aortic-valve surgery was performed. Our observations appear to indicate the early stage in the formation of a mitral-valve aneurysm.