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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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
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 (firstname.lastname@example.org).
Conflict of Interest Disclosures: None reported.
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:
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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