Mural endocarditis

Mural endocarditis Vegetations in infective endocarditis are usually situated on the valves. If they are located on the walls of the cardiac chambers, it is known as mural endocarditis [1]. When mural endocarditis occurs without any cardiac structural abnormalities like ventricular septal defects, it is called primary mural endocarditis [2]. Primary mural endocarditis is extremely rare. Left atrial mural endocarditis usually occurs due to the jet lesion of mitral regurgitation [1,3]. Left atrial mural endocarditis is usually picked up by trans esophageal echocardiography. Vegetations are mostly located just distal to the mitral orifice between the high pressure jet and a low pressure sink. This concept was well explained by Rodbard in 1963 [4]. He noted that endocarditis occurs when a high pressure source extrudes blood at critical velocities through a narrow orifice into a low pressure sink. The following picture illustrates this concept. High pressure source and low pressure sink High velocity jets of mitral or aortic regurgitation on the cardiac chamber wall produces endothelial denudation. Platelets and fibrin get deposited on these jet lesions and serves as a nidus for endocarditis during transient bacteremia. It has been suggested that when surgical treatment is planned for endocarditis, complete removal of these lesions is necessary to clear bacteremia, decrease embolic complications and prevent relapse after completion of antibiotic therapy [5]. Jet lesions will be in...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs