Key result
POCUS rapidly identifies aortic valve vegetation to guide emergent surgery in acute heart failure.
Why the study?
While point-of-care echocardiography is well documented for identifying tricuspid vegetations, aortic valve involvement and subsequent heart failure are less well described.
Case Report (n=1)
No
Point-of-care ultrasound can rapidly identify aortic valve vegetations in the emergency department, expediting life-saving surgical intervention for infective endocarditis.
May aid rapid aortic valve vegetation detection in acute HF; hypothesis-generating and should not yet change practice.
INTRODUCTION: Infective endocarditis (IE) is a life-threatening condition with significant morbidity and mortality, and can require surgical repair. CASE REPORT: A 36-year-old man presented to the emergency department for worsening dyspnea and chest pain. Point-of-care echocardiography demonstrated a mobile oscillating mass on the aortic valve with poor approximation of the valve leaflets, suggesting aortic valve insufficiency secondary to IE as the cause of acute heart failure. The patient underwent emergent aortic valve replacement within 24 hours. DISCUSSION: While point-of-care echocardiography has been well documented in identifying tricuspid vegetations, aortic valve involvement and subsequent heart failure is less well described. Earlier recognition of aortic valve vegetations and insufficiency can expedite surgical intervention, with decreased complication rates linked to earlier antimicrobial therapy. CONCLUSION: This case report highlights the ability of point-of-care ultrasound to identify aortic vegetations, allowing for the earlier diagnosis and therapy.
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Gallagher et al. (2020) conducted a case report in Acute heart failure due to infective aortic endocarditis (n=1). Point-of-care ultrasound was evaluated. Point-of-care ultrasound successfully identified an aortic valve vegetation in a 36-year-old man presenting with acute heart failure, allowing for rapid diagnosis and emergent surgical intervention.
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