Aortic valve endocarditis in hemodialysis patients complicated with ischemic heart attack

introduction catheter infection is a common complication in hemodialysis patients and sometimes cmplicated by endocarditis. the most common valve that involved in these patients is tricuspid valve. we have a case on hemodialysis with endocarditis of Aortic valve whose coarse was complicated with an ischemic heart attack.abstract a 65 year old diabetic man on hemodialysis was admitted with chief complaint of fever. he underwent hemodialysis 3 times weekly via permanent subclavian catheter. He received vancomycin and meropenem. His echocardiography revealed that there is a vegetation on his aortic valve and recommended transesophageal echocardiography for further evaluation. two days later he developed hypotension and cold sweating, hie ECG revealed ST-T changes, result of troponin was negative. Hewas admitted at CCU and underwent TEE. the finding was a large echodensic mass (2.1*1.9 cm) on LCC with intermittent protrusion to LM orifice and with 2 moving particle. Blood culture show growth of staph epdermidis . he referred to cardiac surgeon emergently.discussion It seems that clinical coarse of our patient was complicated with an ischemic episode. it seems that large size vegetation occluded the orifice of left main artery temporarily and induce the ischemic attack which present with hypotension, diaphoresis and ECG changes.

Keywords:

aortic valve , endocarditis , ischemic heart attack