Fungal Whip Beats the Heart
A24-year-old man was admitted to the hospital because of fever, cough, and dyspnea of 4 weeks’ duration. The patient gave a history of parenteral drug abuse since he was 17 years old and had been diagnosed with HIV infection 4 years before admission. A chest radiograph showed multiple alveolar infiltrates. Four blood cultures were positive for Candida albicans.
Different echocardiographic views of the right heart cavities are shown in the Figure⇓. A long, highly mobile, and whiplike structure can be seen attached to the nonseptal leaflet of the tricuspid valve, traveling from the right atrium (RA) to the right ventricle (RV) with each cardiac cycle. It represents a bizarre form of fungal vegetation that hits the patient’s heart with each cardiac beat.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
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