THE COURSE OF A REVERSIBLE CONTACT LESION IN MITRAL-VALVE ENDOCARDITIS, OBSERVED BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY

This is a case report of a 59-year-old patient with an endocarditis of the mitral valve caused by streptococcus viridans. Precordial echocar diography showed a highly mobile vegetation of the anterior mitral lea flet prolapsing during systole into the left atrium. During diastole c ontact with the ventricular septum caudally to the left ventricular ou tflow tract was noted. By using transesophageal echocardiography (TEE) , this zone appeared as a localized increased echogenity of the pariet al endocardium and underlying myocardium. Antibiotic therapy led to a cure of the endocarditis (clinically and according to clinical chemist ry). The TEE follow-up 2 months later showed persisting mitral valve v egetation, whereas neither the endocardial lesion nor the abnormal myo cardial echo pattern were seen any longer. The likely inflammatory eti ology of the described lesion is discussed and seems obvious.