Presentation
Acute onset chest pain radiating through to the left shoulder blade with lactate 5.7, normal ECG, ongoing pain, ? dissection
Patient Data
Non-contrast and arterial phase contrast-enhanced exam.
Case Discussion
Radiological finding of a filling defect at the aortic valve was initially missed on call by the author, and detected when the exam was checked the next day.
No organisms were ever cultured on multiple blood cultures.
The patient proceeded to theater for aortic valve replacement, a mass was seen surgically, which was sent for pathological analysis. On histology the mass demonstrated mature inflammatory changes, no evidence of dysplasia and no micro-organisms stained, however the appearances were described as being in keeping with endocarditis.
The patient remains under cardiology follow-up.
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