Is infectious endocarditis a rare cause of stroke in a young patient?

Introduction: Infectious endocarditis has an incidence of 3 to 9 in 100,000 people and appears in more than 50% of cases in patients with valvular heart disease, patients with prosthetic heart valves and patients with untreated congenital cardiomyopathy. Despite multiple diagnostic and treatment techniques, infectious endocarditis is still a disease with a high level of morbidity and mortality. Methods: We present the case of a 37 years old patient with a history of aortic valve endocarditis in 2008, treated with antibiotics. The patient, afterwards presenting 4 ischemic strokes, was admitted with aggravated dyspnea in the previous 2 weeks. Clinical and paraclinical investigations confirm the existence of a severe aortic valve disease (severe aortic insufficiency aft er endocarditis with small and mobile vegetations attached on the valve) on a pacient with significant atherosclerotic lesions at the carotid arteries (bilateral occlusion of the internal carotid). The patient was then addressed to a cardiothoracic surgeon who performed bilateral carotid endarterectomy and inserted an aortic valve prosthesis, with favorable outcome. Results: Stroke is one of the major complications that can appear in a patient with a history of bacterial endocarditis, with an incidence of 20% of all complications. Ischemic stroke is more common than hemorrhagic stroke in these patients. The association of atherosclerotic carotid disease increases the risk of neurologic complications. Conclusions: The risk of neurologic complications in patients with infectious endocarditis is relatively small. However, the association of severe atherosclerotic carotid disease in a young patient is rare.

Search in archive

Submit article






Subscriptions

If you wish to receive the Romanian Journal of Cardiology, even if you are not a member of the Romanian Society of Cardiology, please fill in the form below, the annual cost (4 issues) being 195RON.

Payment can be made in the account of the Romanian Society of Cardiology:
RO28BTRL04101205M6647601, opened at Banca Transilvania, the Division for Medical Doctors from Cotroceni.

After having made the payment, please offer proof , by sending a copy from the bill or order of payment via e-mail: office@cardioportal.ro