Aorta-to–Left Atrium Fistula
A Complication of Endocarditis
A 75-year-old woman was evaluated for endocarditis at New York University Medical Center. She had a history of aortic valve replacement with a bioprosthesis for aortic insufficiency in 1996. Blood cultures were positive for enterococcus. On the second hospital day, the patient abruptly developed hypotension and dyspnea. Physical examination revealed that she was in shock with pulmonary edema, and a continuous murmur was present. An emergency transesophageal echocardiogram was performed at the bedside (Figure⇓).
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.
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