Author + information
- Received January 26, 2010
- Accepted February 12, 2010
- Published online December 7, 2010.
A 58-year-old Latino man with heavy alcohol use presented to the emergency room with 1 month's worth of weakness, fevers, chills, weight loss, and murmur. Blood cultures grew alpha-gram positive cocci in clusters. A 2- and 3-dimensional transesophageal echocardiogram revealed a large 3.2 × 4.0-cm echo density (arrows)attached to the pulmonic valve and annulus (A and B, Online Videos 1and 2). The mass caused a moderate systolic obstruction and prolapsed into the right ventricular outflow tract during diastole as confirmed by cardiac catheterization (C and D, Online Video 3). The blood cultures later grew Abiotrophianutritional variant streptococci. The patient underwent surgical excision of the mass (E)and had a pulmonary valve replacement with a 27-mm Epic tissue valve (St. Jude Medical, St. Paul, Minnesota). Pathological analysis revealed a cardiac myxoma with colonization of gram-positive cocci (F to I). The patient had no complications. This is an extremely rare case of myxoma in the right-sided valves, especially with concurrent bacteremia and superinfection.
- Received January 26, 2010.
- Accepted February 12, 2010.
- American College of Cardiology Foundation