A vegetation on the surface of left ventricular muscle and subvalvular
tissue just below the anterolateral commissure of the mitral valve
without exposure to regurgitation or shunt jet
Abstract
Bacteria can adhere to cardiac endothelium damaged by regurgitation or
shunt jet; however, healthy cardiac endothelium is supposedly resistant
to bacterial adhesion. Bacterial vegetations are most common on cardiac
valves, but are rarely observed at other sites. We report a case of a
vegetation on the surface of left ventricular muscle/subvalvular tissue
without regurgitation or shunt jet. Transthoracic echocardiography did
not detect the vegetation because of its unique location; however,
transesophageal echocardiography (TEE) did detect. In conclusion,
vegetations can form without exposure to regurgitation or shunt jet, and
TEE is highly sensitive for detecting the vegetation in unusual
locations.