RT Book, Section
A1 Kulshreshtha, Sarthak
A1 Hassan, Muhammad
A2 Saad, Muhammad
A2 Vittorio, Timothy J.
SR Print(0)
ID 1183948639
T1 COVID-19 Management Strategies
T2 COVID-19 and the Heart: A Case-Based Pocket Guide
YR 2022
FD 2022
PB McGraw Hill
PP New York, NY
SN 9781264266708
LK accesscardiology.mhmedical.com/content.aspx?aid=1183948639
RD 2023/03/21
AB A  71-year-old  Hispanic  man  with  medical  comorbidities  of  diabetes  mellitus,  hypertension,  abnormal  functioning  bioprosthetic  aortic  valve  (severe  aortic  stenosis),  and  chronic  kidney  disease  was  admitted  with  COVID-19  pneumonia  confirmed  with  nasopharyngeal  COVID-19  reverse-transcription-polymerase  chain  reaction  (RT-PCR)  test.  The  patient  received  tocilizumab,  remdesivir  and  dexamethasone  with  marked  signs  of  improvement.  He  was  discharged  home  on  a  tapering  dose  of  prednisone  and  home  oxygen.  He  was  readmitted  3  months  later  with  fever  and  chills.  His  blood  cultures  grew  methicillin-sensitive  Staphylococcus  aureus.  He  was  started  on  intravenous  antibiotics  for  4  weeks  but  remained  febrile  with  persistent  bacteremia.  An  electrocardiogram  showed  third-degree  heart  block  (Figure  10-1A).  The  patient  underwent  a  transesophageal  echocardiogram  (TEE)  for  evaluation  of  endocarditis  (Figure  10-1B).  The  TEE  showed  aortic  valve  vegetation  with  aortic  root  and  aortomitral  curtain  thickening  suspicious  of  abscess  (Figure  10-1C).  He  underwent  aortic  root  abscess  drainage  and  implantation  of  a  redo  bioprosthetic  aortic  valve  with  transvenous  pacemaker  placement.