Summary:
This patient was aware of a systolic murmur. Blood cultures were positive
for Strep viridans. An echocardiogram confirmed the presence of mitral regurgitation and showed vegetations on the mitral leaflets.
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to review auscultation.
Lessons:
- The location, quality, and loudness of this murmur were important in
considering mitral regurgitation as the cause.
- Transesophageal echocardiography is often the best way to evaluate the possibility of valvular vegetations.In this case this was not necessary because the trans-thoracic echo had demonstrated vegetations. These abnormalities will disappear with antibiotic therapy.
- Once the infection is cured, he should be able to resume full activity but he should be advised to have routine follow up evaluations every two years.
Case 8 is now finished.