A Rare Case of Infective Endocarditis Complicated with a Cardiac Abscess Causing Heart Block

Individuals that have undergone cardiac surgery or heart valve replacement are at increased risk for developing Infective Endocarditis (IE). IE has numerous signs and symptoms as well as complications. However, an interesting and unique presentation of IE can be in an individual showing a complete heart block on EKG. A heart block from an IE will typically present with a cardiac abscess on Transesophageal Echocardiogram (TEE) and coronary Computed Tomography Angiography (CTA). This individual, with a past medical history of transcatheter aortic valve replacement in 2011, was found to have Enterococcus faecalis bacteremia and endocarditis. Soon after discovery of the infection, CTA of the coronaries showed a 7.6 × 4.6 × 2.5 cm loculated pericardial collection consistent of a cardiac abscess. Despite the initiation of antibiotic therapy, this gentleman with bacterial endocarditis had an increased risk of immediate mortality, due to the complete heart block and additional complications. High clinical suspicion and early intervention are warranted for cases of infective endocarditis.