The use of cardiac MRI in a rare case of primary mural endocarditis

Description

A 47-year-old-man with a history of intravenous drug use and recent diagnosis of T-cell lymphoma returned to the emergency department 1 week after initiation of chemotherapy with complaint of left olecranon swelling. Admission vital signs included body temperature of 36.6°C, blood pressure 108/65, heart rate 76 and respiratory rate 18. Physical examination of the left olecranon revealed that it was warm and indurated. An X-ray of the left olecranon and aspiration of the swelling confirmed bursitis. Both the aspiration culture and blood cultures demonstrated methicillin-resistant Staphylococcus aureus. A transthoracic echocardiogram was subsequently performed revealing a large echodensity in the left ventricular apex (figure 1; see online and ). The patient refused to undergo a transoesophageal echocardiogram due to its invasive approach. Therefore, a cardiac MRI (CMRI) was obtained to evaluate the lesion. The CMRI demonstrated left ventricular ejection fraction 65%, no valvular vegetations and two linear...

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