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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Metallic embolus to the brain in a patient with mechanical heart valves: an extremely rare complication
  1. Shazib Sagheer1,
  2. Abu Baker Sheikh1,
  3. Jon J Hallstrom2 and
  4. Veena Raizada3
  1. 1 Internal Medicine, University of New Mexico Hospital, Albuquerque, New Mexico, USA
  2. 2 Neuroradiology, University of New Mexico Hospital, Albuquerque, New Mexico, USA
  3. 3 Cardiovascular Medicine, University of New Mexico Hospital, Albuquerque, New Mexico, USA
  1. Correspondence to Dr Shazib Sagheer, shazibcheema{at}gmail.com

Abstract

A 46-year-old man with a medical history of rheumatic valve disease underwent mitral and aortic valve replacements with On-X and CarboMedics Top Hat supra-annular mechanical valves, respectively. Seven months after the valve replacement surgery, the patient presented with dizziness. A CT scan of the brain was done as part of a thorough workup of dizziness. The CT scan revealed a small metallic density in the M2 branch of the right middle cerebral artery. The metallic density was believed to be a metallic embolus that originated from the mechanical valves or the suturing material, that is, Cor-Knot fastener. Although in our case, the dizziness was believed to be the result of benign paroxysmal positional vertigo, through this case, we aim to highlight this extremely rare structural complication of mechanical valves. This complication can have serious and potentially fatal consequences such as embolic component-related stroke or another organ infarction.

  • valvar diseases
  • heart failure

https://doi.org/10.1136/bcr-2019-230653

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    Footnotes

    • Contributors SS was involved in the literature search, writing the manuscript and doing the edition. ABS was involved in the patient’s data gathering from the electronic medical record, writing the case presentation, getting consent from the patient and did part of the literature search. JJH helped with selecting images, interpretation of images and writing captions. He also assisted in editing the discussion section. VR participated by reviewing the whole case and then manuscript review and editing. Several revisions were done after feedback from VR and JJH.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.