Ultrasound for Critical Care Physicians: Right Diagnosis, Wrong Place
The patient was a 76 year old man, with a history of a prosthetic aortic valve (aortic stenosis) and chronic myelogenous leukemia. He presented with fever and cough, and was found to have pneumonia with Klebsiella pneumonia cultured from a BAL. However, he also had persistent Enterococcus faecalis bacteremia and a new 3/6 diastolic murmur.
An ultrasound of the heart was performed (Figures 1 and 2).
Figure 1. Parasternal long axis view of the heart.
Figure 2. Four chamber view of the heart.
Which of the following is the likely diagnosis?
- Aortic dissection
- Aortic valve endocarditis
- Displacement of the aortic valve
- Mitral valve endocarditis
- Tricuspid endocarditis
Reference as: Raschke RA. Ultrasound for critical care physicians: right diagnosis, wrong place. Southwest J Pulm Crit Care. 2013;7(4):232-5. doi: http://dx.doi.org/10.13175/swjpcc123-13 PDF