Abstract
Left ventricular (LV) hypertrophy is defined by a thickness
> 15 mm in the adult index case or > 13 mm in
the adult related case [1]
In children, it is defined according to a nomogram based on age and body
surface area. Hypertrophy is usually asymmetrical predominating over the
interventricular septum. [1]
The literature [2,3] , infective endocarditis in patients with
hypertrophic cardiomyopathy (HCM) is virtually limited to isolated
reported cases or groups of cases, therefore the risk of infective
endocarditis during HCM remains poorly defined and thought to be low
because HCM is a disorder of the myocardium and not the
endocardium.[4]
Spirito et al[1] assessed the occurrence of IE in HCM was 4.3% at
10 years and discerned an HCM subgroup with both obstruction and atrial
dilatation prone to develop IE [5]
It is considered low and mostly limited to patients with a subaortic
obstruction at rest and or with an intrinsic mitral defect. [2]
The site of the vegetation is usually the anterior leaflet of the mitral
valve but vegetations have been reported to occur at the septal level
(area of contact with the mitral) and or on the valve [2].
We present a case of infective endocarditis on culture-negative native
mitral valve in a previously asymptomatic 10-year-old child with HCM.
This case is not only a rare pediatric HCM with IE, but it also
demonstrates the invaluable role of imaging in the diagnosis of HCM and
its complications, especially in the case of IE.