[Endocarditis complicated by anterior myocardial infarction: a case report. What the guidelines do not say]

Area of Science:

• Cardiology
• Infectious Diseases
• Vascular Medicine

Background:

• Infective endocarditis rarely causes acute myocardial infarction (AMI), leading to underdiagnosis and high mortality.
• Current guidelines lack specific recommendations for managing AMI secondary to infective endocarditis.
• Septic emboli occluding coronary arteries present a unique diagnostic and therapeutic challenge.

Observation:

• A case of acute coronary syndrome (ACS) caused by septic embolus occlusion of the left anterior descending artery is presented.
• Clinical and diagnostic findings suggestive of endocarditis in the context of ACS are examined.
• The patient was successfully treated with aspiration of the embolic material.

Findings:

• Septic emboli can mimic typical atherosclerotic coronary artery disease, complicating diagnosis.
• Aspiration thrombectomy can be an effective treatment for embolic coronary occlusion in infective endocarditis.
• Variable clinical presentations necessitate a high index of suspicion for endocarditis.

Implications:

• Early suspicion and diagnosis of endocarditis are crucial for patients presenting with ACS.
• A multidisciplinary team approach is essential for optimal diagnostic and therapeutic management.
• Further research is needed to refine treatment guidelines for this uncommon but severe complication.