Congenital Cardiac Defects, Such as Eustachian Valve, May Increase the Risk of Cryptogenic Stroke: A Case Report

• 作者: Anna Balducci Chiara Bandinelli Giampaolo Bianchi Giovanni Maria Puddu Marco Zoli
• 来源期刊: 心血管病(英文)
• 学科: 医学
• 关键词: Eustachian Valve Cryptogenic Stroke Patent Foramen Ovale PFO ENDOCARDITIS Staphylococcus aureus Transesophageal Echocardiography MIGRAINE
• 年，卷（期）: 2020,（6）
• 页码范围: 379-384
• 页数: 6页
• 分类号: R74

摘要

Eustachian valve is an embryonic endocardial heart structure;after birth it becomes an embryogenic residue and its persistance in adult life is unusual.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">The literature reports some cases of association between Eustachian valve and PFO and is known that the prominent Eustachian valve can represent a way facilitating systemic embolism.</span><span style="font-family:""></span><span style="font-family:Verdana;">Several studies also investigated the role of Eustachian valve in the pathophysiology of both migraine and cerebral embolism.</span><span style="font-family:Verdana;"> </span><span style="font-family:""><span style="font-family:Verdana;">In addiction is known how Eustachian valve may increase the risk of endocarditis, which mostly affects intravenous drug abusers or those with implanted medical devices or central venous catheters. The most commonly identified organism is </span><i><span style="font-family:Verdana;">Staphylococcus aureus</span></i><span style="font-family:Verdana;"> (approximately 53% of cases).</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We present a case of a 46-year-old woman with known migraine. She was</span><span style="font-family:Verdana;"> hospitalized in Stroke Unit for a cryptogenic stroke with a right-to-left shunt detected with transcranial doppler ultrasound with “bubble test” and a patent foramen ovale with right-to-left shunt with a fenestration of atrial septum and a voluminous Eustachian valve detected with transesophageal echocardiography;she developed fever with a blood cultures positive for methicillin-resis</span><span style="font-family:Verdana;">- </span><span style="font-family:""><span style="font-family:Verdana;">tant </span><i><span style="font-family:Verdana;">Staphylococcus aureus</span></i><span style="font-family:Verdana;"> (MRSA), even if without evidence of endocarditis vegetations.</span></span><span style="font-f