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Fig. 9 | Critical Ultrasound Journal

Fig. 9

From: Echocardiography in the sepsis syndromes

Fig. 9

Infectious endocarditis in ICU patients. a Patient with septic shock, acute pulmonary edema, and systemic arterial embolization (TEE midesophageal long axis view): massive mobile vegetation (white arrow) on native aortic valve (right cusp; note also anatomic disruption of the non-coronary cusp). See also Video 9A, B ESM. b Febrile dyspnoeic patient (TEE midesophageal long axis view): thin vegetations and cusps perforation on native aortic valve (white arrows). See also Video 10 ESM. c Septic shock patient (TEE midesophageal commissural view): small linear vegetation (white arrow) on prosthetic valve in mitral position. See also Video 11 ESM. d Patient with cardiac tamponade (bloody fluid at pericardiocentesis) and septic shock (TEE midesophageal 2-chamber view): huge mobile vegetation incorporating the posterior mitral leaflet (white arrow); note sub-annular abscess and escavation (red arrow) responsible for subacute LV wall rupture and hemopericardium. See also Video 12 ESM. In Video 13 ESM see in another febrile ICU patient a paravalvular leak, regurgitant jet originating outside the prosthetic valve annulus (red arrow; TEE midesophageal 2-chamber view, mechanical bileaflet valve in mitral position). e Febrile patient with dilated cardiomyopathy and biventricular pacing device (TEE bicaval view): thrombus is evident in the SVC (red arrow), attached to the pacemaker wire (white arrow). See also Video 14 ESM. Note pulmonary embolic lesion at CT-scan (f, red arrow). RA right atrium, LA left atrium, LV left ventricle, Asc AO ascending aorta, SVC superior vena cava

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