ABSTRACT
The association of complete atrioventricular (AV) block with Takotsubo syndrome (TTS) is well known, but the cause-and-effect relationship has not been determined. We present the case of a 91-year-old female with complete AV block who went untreated for over a year and later developed Takotsubo syndrome. Reversal of wall movement defects was seen after a permanent pacemaker was implanted, and routine follow-up showed that the implanted pacemaker worked normally.
ABSTRACT
A 29-year-old female with a history of bioprosthetic mitral valve replacement was admitted with fever, chills, and shortness of breath of two weeks duration. Transthoracic echocardiography revealed a thickened bioprosthetic mitral valve with a 26 mmHg mean gradient consistent with severe mitral stenosis and associated large vegetation. Blood cultures demonstrated no growth. The patient underwent repeat mitral valve replacement surgery. At the time of operation, diffuse mitral valve thickening was observed, causing decreased mobility in both cusps with vegetation covering both sides of the valve. PCR with 16s rRNA sequencing of the tissue specimen revealed Gemella species DNA. Her recovery period was uneventful. Infective endocarditis very rarely causes obstructive/functional stenosis. When present, fungal organisms are typically implicated. These patients often present acutely with distinctive clinical evidence of obstruction, and they usually demonstrate rapid deterioration. Prompt diagnoses and timely surgery are essential.