Eustachian valve endocarditis caused by Streptococcus viridans.

A 76-year-old man was admitted for ethanol detoxification. He was found to be in atrial fibrillation with a rapid ventricular response that was refractory to electrical and chemical cardioversion attempts. The patient subsequently developed respiratory distress. A transesophageal echocardiogram revealed a vegetation attached to the eustachian valve and blood cultures grew Streptococcus viridans. After treatment with appropriate antibiotics, the patient converted to sinus rhythm with sotalol hydrochloride, and the eustachian valve vegetation resolved. This is the first reported case of eustachian valve endocarditis caused by S viridans.