Pulmonic Valve Endocarditis with An Underlying Ventricular Septal Defect: A Report on Three Cases at the Philippine General Hospital

DOI: 10.5176/2382-5669_CCMR13.12

Authors: Jaime Alfonso M. Aherrera MD, Michael Joseph T. Reyes MD, Geraldine O. Floro MD, Edgar Timbol MD, Jan Melvin Zapanta MD, Louren R. Blanquisco MD, Kristine D. Tumabiene MD and Felix Eduardo Punzalan MD

Abstract:

Pulmonic valve endocarditis (PVE) is considered a rare disease, noted in 1.5 to 2.0{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465} of all cases of infective endocarditis, with fewer than 90 cases reported. Its occurrence warrants investigation of possible risk factors that would predispose an individual to such a right sided event, such as an underlying congenital heart disease with a left-to-right shunt. In this case, PVE is precipitated by turbulence of high blood flow from the left side of the heart across the right ventricular outflow tract (RVOT). We present three cases of PVE with an underlying ventricular septal defect (VSD) encountered at the Philippine General Hospital. Two were discharged with medical therapy, but one case succumbed to a possible pulmonary embolic phenomenon. These cases illustrate an important point – clinical history and a high index of suspicion are still the most important instruments in diagnosing infective endocarditis.

Keywords: pulmonic valve endocarditis, ventricular septal defect, endocarditis