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QT Prolongation Complicated with Torsades de Pointes in Prosthetic Mitral Valve Endocarditis: A Case Report.

Tounsi A, Abid L, Akrout M, Hentati M, Kammoun S - Case Rep Med (2012)

Bottom Line: The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after.He continued on triple antibiotic therapy for 45 days with a good revolution.The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department, Hedi Chaker University Hospital, Sfax 3029, Tunisia.

ABSTRACT
We present the case of a 49-year-old male patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. He was asymptomatic until the end of January 2012, when he was admitted to our hospital emergency unit because of syncope, fever, and suspicion of endocarditis. Cardiologic evaluation was requested and the transthoracic (TTE) and transesophageal (TEE) echocardiograms revealed vegetations on the prosthetic mitral valve. All cultures were positive for methicillin-sensitive Staphylococcus aureus. The corrected QT (QTc) interval was markedly prolonged upon admission (QTc 540 ms). He experienced torsades de pointes (TdP) several times and he was recovered after bystander cardiopulmonary resuscitation. The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after. He continued on triple antibiotic therapy for 45 days with a good revolution. The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

No MeSH data available.


Related in: MedlinePlus

Transesophageal echocardiography (TEE) revealed vegetation on the anterior mitral annulus (1.2 ∗ 0.5 cm).
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fig2: Transesophageal echocardiography (TEE) revealed vegetation on the anterior mitral annulus (1.2 ∗ 0.5 cm).

Mentions: Because of high clinical suspicion, transesophageal echocardiography (TEE) was done, which revealed vegetation on the anterior mitral annulus (1.2 ∗ 0.5 cm) (Figure 2). A diagnosis of IE was made and an empirical antibiotic regimen of vancomycin 2 g/day, gentamycin 160 mg/day, and rifampicin 1200 mg/day was started on the first day of admission. Cultures were positive for methicillin-sensitive Staphylococcus aureus. So the antibiotic regimen was changed to oxacillin (2 g ∗ 6/day), rifampicin (600 mg/day), and gentamycin (160 mg/day).


QT Prolongation Complicated with Torsades de Pointes in Prosthetic Mitral Valve Endocarditis: A Case Report.

Tounsi A, Abid L, Akrout M, Hentati M, Kammoun S - Case Rep Med (2012)

Transesophageal echocardiography (TEE) revealed vegetation on the anterior mitral annulus (1.2 ∗ 0.5 cm).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472411&req=5

fig2: Transesophageal echocardiography (TEE) revealed vegetation on the anterior mitral annulus (1.2 ∗ 0.5 cm).
Mentions: Because of high clinical suspicion, transesophageal echocardiography (TEE) was done, which revealed vegetation on the anterior mitral annulus (1.2 ∗ 0.5 cm) (Figure 2). A diagnosis of IE was made and an empirical antibiotic regimen of vancomycin 2 g/day, gentamycin 160 mg/day, and rifampicin 1200 mg/day was started on the first day of admission. Cultures were positive for methicillin-sensitive Staphylococcus aureus. So the antibiotic regimen was changed to oxacillin (2 g ∗ 6/day), rifampicin (600 mg/day), and gentamycin (160 mg/day).

Bottom Line: The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after.He continued on triple antibiotic therapy for 45 days with a good revolution.The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department, Hedi Chaker University Hospital, Sfax 3029, Tunisia.

ABSTRACT
We present the case of a 49-year-old male patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. He was asymptomatic until the end of January 2012, when he was admitted to our hospital emergency unit because of syncope, fever, and suspicion of endocarditis. Cardiologic evaluation was requested and the transthoracic (TTE) and transesophageal (TEE) echocardiograms revealed vegetations on the prosthetic mitral valve. All cultures were positive for methicillin-sensitive Staphylococcus aureus. The corrected QT (QTc) interval was markedly prolonged upon admission (QTc 540 ms). He experienced torsades de pointes (TdP) several times and he was recovered after bystander cardiopulmonary resuscitation. The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after. He continued on triple antibiotic therapy for 45 days with a good revolution. The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed.

No MeSH data available.


Related in: MedlinePlus