Teddy bear in the heart

Abstract

In a patient with native aortic valve endocarditis, transoesphageal echocardiography yielded a teddy bear appearance which is not reported so far. A perivalvular abscess ( right ear), the superior vena cava in cross section ( left ear) and the dilated ( post-stenotic) aortic root ( face) made up the teddy bear. This was not a cuddlesome toy but an ominous sign. The genesis of perivalvular abscess as well as the role of transoesphageal echocardiography in its diagnosis and treatment are briefly reviewed.