BMJ Case Reports 2017; doi:10.1136/bcr-2017-219490

Penetrating mitral annular abscess ruptured into the left atrium: a rare cause of mitral regurgitation

  1. Paul V George2
  1. 1Department of Cardiology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
  2. 2Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
  1. Correspondence to Dr Gopal Chandra Ghosh, gcghosh86{at}
  • Accepted 7 February 2017
  • Published 21 February 2017


A man aged 27 years from Bangladesh was referred to our centre for evaluation of fever of unknown origin of 3 months duration. There was a history of progressively increasing dyspnoea of NYHA functional class II for 25 days. He had received antibiotic therapy for a week prior to his presentation to us. Physical examination revealed muffled first heart sound with loud pulmonary component of second heart sound. A grade IV/VI (Levine grade) pan systolic murmur was heard over the apex, radiating to the left axillae. There were no clinical stigmata …

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