Title: Enterococcal Prosthetic Valve Infective Endocarditis Presenting as Complete Heart Block with Intramyocardial Abscess Causing Asystolic Cardiac Arrest

Abstract:

The extension of an intracardiac abscess causing complete heart block is a rare complication of infective endocarditis that is associated with a high mortality. Early identification of conduction abnormalities and a low threshold for suspecting infective endocarditis is crucial to provide prompt management to prevent intracardial extension of infection. We report a case of a patient presenting with complete heart block in the setting of profound hyperkalemia, and was then found to have enterococcal prosthetic valve endocarditis, which was complicated by an intracardiac aortic root abscess which led to asystolic cardiac arrest. The development of heart block in endocarditis serves as a marker for poor prognosis and can signify progression of infection. Management therefore requires immediate pacing, antibiotic delivery to lessen infectious burden, and evaluation for consideration of surgical options such as valve replacement. It is therefore recommended for patients with endocarditis complicated by conduction abnormalities or intracardial abscesses to be treated by a multi-disciplinary team consisting of cardiologists, cardiothoracic surgeons, and infectious disease specialists.

Biography:

Ben Borokhovsky is a current internal medicine resident at Lehigh Valley Health Network. He completed his medical education at Cooper Medical School of Rowan University. He completed his undergraduate education at Widener University and graduated Summa Cum Laude with a degree in Biochemistry. Ben did research throughout his entire undergraduate education and has consistently been asked to speak at Widener’s Research Symposium and has given a keynote presentation on his senior thesis, for which he won a first-place award. During his time at Cooper Medical School of Rowan University, Ben’s research led to multiple publications in the fields of internal medicine, cardiology, endocrinology, and biochemistry. He has attended and presented his research at various conferences including the Annual Drosophila Research Conference hosted by the Genetics Society of America and the International Conference on Human Genetics and Genetic Diseases.