Fatal Embolic ST-Elevation Myocardial Infarction Secondary to Healed-Phase Mitral Valve Infective Endocarditis

Area of Science:

• Cardiology
• Infectious Diseases
• Pathology

Background:

• Embolic myocardial infarction (MI) due to infective endocarditis (IE) is an uncommon yet significant complication.
• It predominantly affects patients with aortic valve IE during acute infection and is associated with high mortality.
• Management strategies remain unclear due to limited data, with diagnosis often indirect via imaging.

Observation:

• This case report details a fatal embolic ST-elevation MI (STEMI).
• The STEMI was caused by mitral valve IE.
• Notably, this occurred during the healed phase of the infection, a less typical presentation.

Findings:

• Pathological examination definitively confirmed embolic STEMI secondary to mitral valve IE.
• The event occurred during the healed phase of IE, challenging typical clinical expectations.
• This contrasts with the more common presentation of aortic valve IE during acute infection.

Implications:

• This case underscores the potential for severe cardiac complications from IE, even in its healed phase.
• It highlights the importance of considering IE as a cause of MI, irrespective of the infection's acute status.
• Further research is needed to clarify diagnostic and management guidelines for IE-related embolic MI.