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患者男,34岁。因发热伴乏力2月余入院。查体:左手小指掌指关节处可见Osler结节,胸骨右缘第2肋间闻及Ⅲ/Ⅳ级舒张期杂音。血培养检查发现草绿色链球菌。经食管超声所见:主动脉瓣呈二叶,斜裂式,为左前,右后瓣,左前瓣可见浅嵴回声,二叶瓣表面附着数个大小不等附加弱回声,随心动周期有明显形变(图1a);瓣叶开放尚可,关闭时中度反流,反流束向后冲击二尖瓣前叶,致前叶瓣体呈瘤样
Patient male, 34 years old. Fever due to fever with more than 2 months admitted to hospital. Physical examination: the left hand little finger Osseous joints seen Osler nodules, sternum right intercostal space smell 2 and Ⅲ / Ⅳ diastolic murmur. Blood culture examination found Streptococcus viridans. Transanal esophageal ultrasound findings: aortic valve was two lobes, oblique fissure, left anterior, right posterior flap, left anterior eyelid visible shallow crest echo attached to the surface of the two lobes ranging from the size of the attached additional weak echo, with significant cardiac cycle Deformation (Figure 1a); open the valve leaflets can be moderate closure when the reflux, the backward flow of backward impact mitral valve anterior lobe, causing the anterior lobe valve was tumor-like