Splenic artery aneurysm and infarction during pregnancy from infective endocarditis

BMJ Case Rep. 2024 Nov 25;17(11):e260923. doi: 10.1136/bcr-2024-260923.

Abstract

Rheumatic heart disease (RHD) remains the leading cardiac problem affecting pregnant women, especially in low- to middle-income countries. In nearly one-third of the cases, it is detected during pregnancy when they present with complications. Infective endocarditis (IE) in pregnancy is rare, with an incidence of 1 in 100 000 pregnancies, and carries high maternal and fetal morbidity and mortality. Embolisation of the infective vegetation can lead to inoculation of the arterial wall, causing aneurysm, infarction or abscess formation. Being an end artery, splenic artery aneurysm and infarct can complicate IE; it can even be lethal due to ruptured aneurysm with intraperitoneal bleed. We report a patient who presented with IE complicated with a splenic-artery aneurysm during pregnancy, successfully managed by a multidisciplinary team.

Keywords: Cardiovascular medicine; Obstetrics and gynaecology; Pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm / complications
  • Aneurysm / diagnosis
  • Aneurysm / diagnostic imaging
  • Endocarditis / complications
  • Endocarditis / diagnosis
  • Endocarditis, Bacterial / complications
  • Endocarditis, Bacterial / diagnosis
  • Female
  • Humans
  • Infarction / diagnostic imaging
  • Infarction / etiology
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis
  • Pregnancy Complications, Infectious / diagnosis
  • Rheumatic Heart Disease / complications
  • Splenic Artery* / diagnostic imaging