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Infective endocarditis presenting as ST-elevation myocardial infarction: an angiographic diagnosis

Benjamin Hibbert1, Mustapha Kazmi, John P Veinot

  • 1Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

The Canadian Journal of Cardiology
|March 3, 2012
PubMed

Insights

Infective endocarditis rarely causes ST elevation myocardial infarction due to coronary artery embolization. This case highlights challenges in diagnosing and managing this rare complication of infective endocarditis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Systemic embolic events are common in infective endocarditis (IE).
  • Coronary artery embolism causing ST elevation myocardial infarction (STEMI) is rare.
  • Early recognition and management of IE complications are crucial.

Observation:

  • A patient presented with septic shock, ventricular fibrillation, and anterior STEMI.
  • Diagnostic angiography revealed IE of a native bicuspid aortic valve with a root abscess.
  • Left anterior descending artery occlusion was identified.

Findings:

  • Histologic examination of the embolectomy specimen confirmed bacterial thrombus in the left anterior descending artery.
  • The findings confirmed coronary embolism of vegetations from IE as the cause of STEMI.
  • This case underscores the diagnostic and therapeutic challenges.

Implications:

  • Coronary embolism should be considered in patients with IE and myocardial infarction.
  • Multidisciplinary management is essential for patients with IE and embolic complications.
  • Further research is needed to improve diagnostic and treatment strategies for coronary embolism in IE.

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