Isolated Right-Sided Infective Endocarditis—An Infected Right Ventricular Myxoma Masquerading as “Tricuspid Vegetation”—A Case Report

Abstract

Aim: To report a case of right ventricular myxoma prolapsing through the tricuspid valve with an attachment of vegetation in a 3-year-old male child. Introduction: Right-sided endocarditis commonly involves the tricuspid valve. Low pressure and low oxygen saturation in the right sided cardiac chambers protect the tricuspid and pulmonary valves from being subjected to excessive strained and damage occurs from injected particulate matter, contaminated venous lines and drug solutions causing endocarditis. RV (right ventricular) myxoma harboured the infection due to trauma as a result of friction movement across the tricuspid valve. Case Report: A 3-year-old male child having the spikes of fever for 2 weeks, presented with tumor "plop" and 3/6 systolic murmur in lower left sternal border and echocardiography revealed a tumor-mimicking vegetation visible as a mass lesion across the tricuspid valve, which is attached to the interventricular septum by a pedicle suggesting a RV myxoma. The vegetation was found to be attached with the tumor and it disappeared with antibiotics and aspirin therapy and the child was advised surgical removal of the tumor. Conclusion: A diagnosis of infective endocarditis can be made in tricuspid valve dysfunction with a floating mass and fever. The cardiac myxoma with an attached vegetation is masquerading as vegetation mass on transthoracic echocardiography in this child.

Mitral Regurgitation on Native Valve with Ostium Secundum Atrial Septal Defect (ASD) Realizingtiger Stripes Sign that Disappear after Mechanical Valve Replacement Case Report with Literature Review

“…1,2 However; it can be associated with any other intracardiac oscillatory mass or vibratory structure, 3,4 or even with native valve regurgitation, as was reported by Goyal (Goyal et al 2018 The tiger stripes sign is not specific to a certain valvular. A case reported by Muthiah (Muthiah 2018) showed the appearance of tiger stripes at the tricuspid valve due to the oscillating mass across the valve. 7 as well as Sahu's case (Sahu et al 2016) showed the tiger stripes within the tricuspid regurgitation arising probably due to abnormal septal tricuspid leaflet oscillatory motion with the jet of TR.…”