A Rare Association of Hypertrophic Cardiomyopathy and Infective Endocarditis: Case Report and Literature Review

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder, affecting approximately 1 in 500 individuals. Although patients with structural heart disease are considered at increased risk of infective endocarditis (IE), its occurrence in HCM remains exceedingly rare. We report the case of an 84-year-old woman with known HCM who presented with progressive dyspnea, fever, and a new systolic murmur. Transthoracic echocardiography demonstrated a mobile vegetation measuring 10 × 10.3 mm attached to the aortic valve, with preserved left ventricular ejection fraction. Blood cultures were positive for Streptococcus viridans, confirming the diagnosis of IE. The patient was managed with intravenous antibiotic therapy, but her subsequent clinical course could not be fully documented. This case highlights the uncommon occurrence of IE in patients with HCM and underscores the pivotal role of echocardiography and microbiological confirmation in establishing the diagnosis. A brief review of the literature shows that IE in HCM is associated with significant morbidity and mortality, with the mitral valve being most frequently affected, but the aortic valve can also be involved. Our observation adds to the limited number of published cases and emphasizes the importance of early recognition and multidisciplinary evaluation in this challenging clinical scenario.