Abstract
Bacteria can adhere to cardiac endothelium damaged by regurgitation or shunt jet; however,
healthy cardiac endothelium is supposedly resistant to bacterial adhesion. Bacterial vegetations are most common on cardiac valves, but are rarely observed at other sites. We report a case of a
vegetation on the surface of left ventricular muscle/subvalvular tissue without regurgitation or shunt jet. Transthoracic echocardiography did not detect the vegetation because of its unique
location; however, transesophageal echocardiography (TEE) did detect. In conclusion, vegetations can form without exposure to regurgitation or shunt jet, and TEE is highly sensitive for detecting the vegetation in unusual locations.
Keywords: infective endocarditis, vegetation, transthoracic echocardiography, transesophageal
echocardiography, regurgitation, shunt jet