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A Man in His 30s With Splenic Infarct and Stroke

To identify the key insights or developments described in this article
1 Credit CME

A man in his 30s with a history of polysubstance misuse was admitted for a splenic infarct and later experienced a right-sided ischemic stroke. His blood cultures grew Enterococcus faecalis. Transesophageal echocardiography showed a quadricuspid aortic valve (QAV) (Figure, A, and Video) with moderate aortic regurgitation and multiple tissue-density masses on the inflow side of the leaflet cusps (Figure, B). He ultimately underwent successful surgical bioprosthetic aortic valve replacement with no postoperative complications.

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Article Information

Published Online: February 1, 2023. doi:10.1001/jamacardio.2022.4603

Corresponding Author: Harry Wang, MD, Department of Cardiology, University of Rochester Medical Center, 601 Elmwood Ave, Box 679A, Rochester, NY 14642 (harry_wang@urmc.rochester.edu).

Conflict of Interest Disclosures: None reported.

References
1.
Tsang  MYC , Abudiab  MM , Ammash  NM ,  et al.  Quadricuspid aortic valve: characteristics, associated structural cardiovascular abnormalities, and clinical outcomes.   Circulation. 2016;133(3):312-319. doi:10.1161/CIRCULATIONAHA.115.017743PubMedGoogle ScholarCrossref
2.
Hurwitz  LE , Roberts  WC .  Quadricuspid semilunar valve.   Am J Cardiol. 1973;31(5):623-626. doi:10.1016/0002-9149(73)90332-9PubMedGoogle ScholarCrossref
3.
Timperley  J , Milner  R , Marshall  AJ , Gilbert  TJ .  Quadricuspid aortic valves.   Clin Cardiol. 2002;25(12):548-552. doi:10.1002/clc.4950251203PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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