Case Report

Prosthetic Valve Endocarditis Presenting as Loss of the Metallic Click Sound

Authors: Antoine G. Sreih, MD, Rahul Mehta, MD

Abstract

Prosthetic valve endocarditis is a significant infection. It is often serious, and may result in a complicated course leading to valvular malfunction. We present the case of a 50-year-old male with an aortic Medtronic Hall valve, who presented with loss of his normal metallic click. A transthoracic echocardiogram confirmed the diagnosis of endocarditis and of an aortic-root abscess. Blood cultures were positive for nutritionally deficient Streptococcus. He underwent successful surgery and later was discharged. Patients with mechanical heart valves are often bothered by the metallic sound. It can interfere with their daily life. However, the loss of the click may indicate valvular dysfunction, dehiscence of the prosthesis, and/or tissue infection with abscess formation.


Key Points


* Infective endocarditis of a mechanical heart valve is a grave disease and may lead to malfunction of the valve.


* The presentation of endocarditis can be subtle, resulting in a delayed diagnosis.


* The metallic clicking sound produced by a mechanical valve frequently bothers patients and can interfere with their quality of life.


* The loss of the clicking sound can be a serious presenting symptom of endocarditis, and may indicate valvular dysfunction and tissue extension of the infection.

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