Infective endocarditis in hypertrophic cardiomyopathy: Case report and review of literature 1961-1982

Infective endocarditis in patients with hypertrophic cardiomyopathy is frequently reported, though it may not be uncommon. A case of infective endocarditis in which Streptococcus viridans was isolated from the skin and blood cultures is described in a patient with hypertrophic obstructive cardiomyopathy. The primary event leading to bacteremia and endocarditis was a skin reaction to antiarrhythmic treatment with amiodarone. An analysis of the 39 documented cases of infective endocarditis among approximately 500 patients with hypertrophic carcinomyopathy during the years 1961-1982 is presented. Particular attention is given to the site of infection, type of bacteria, precipitating causes, and mortality rate. In the majority of cases mitral regurgitation and a large intraventricular gradient were found. Endocarditis can involve the aortic or the mitral valve, or both in the same event. The commonest recognized etiologic agent was S. viridans. From a review of the data it is clear that in patients with hypertrophic obstructive cardiomyopathy, preventive treatment for infective endocarditis is mandatory.