Fulminant Acute Aortic Regurgitation in Infective Endocarditis: Two Fatal Case Reports

Abstract

Background: Acute aortic regurgitation is an uncommon but life-threatening complication of infective endocarditis. It results from rapid destruction of the aortic valve or extension of infection to surrounding structures, leading to abrupt hemodynamic deterioration that often requires urgent surgical intervention. Case presentation: We report two cases of fulminant acute aortic regurgitation complicating infective endocarditis. The first patient, a 58-year-old woman, presented with Staphylococcus haemolyticus infection associated with extensive destruction of the aortic cusps and torrential regurgitation. The second patient, a 46-year-old woman, developed severe acute aortic regurgitation due to infective endocarditis complicated by a mitro-aortic trigone abscess and cusp prolapse. In both cases, transesophageal echocardiography was essential in identifying the severity of valvular damage and establishing the indication for urgent surgery. Despite appropriate antibiotic therapy and intensive medical care, both patients experienced rapid clinical deterioration and died before surgical intervention could be performed. Conclusion: These cases highlight the fulminant course and poor prognosis of acute aortic regurgitation complicating infective endocarditis. Early echocardiographic diagnosis and immediate surgical referral are crucial to improve patient outcomes.