Systemic aspergillosis as cause of myocardial infarction

Systemic aspergillosis is encountered with increasing prevalence in immunocompromised patients undergoing chemotherapy. The current communication describes the clinical and postmortem findings in three leukemic patients who developed myocardial infarction secondary to Aspergillus embolization of the coronary arteries. They were all immunosuppressed owing to previous chemotherapy and had been treated for suspected fungal infection with amphotericin B (0.6 mg/kg) for at least 1 week prior to this episode. It is postulated that the infection was spread through the blood since in all three cases the descending branch of the left coronary artery was occluded. Heart involvement resulting from fungal infection should be suspected when chest symptoms of unknown origin occur in this patient population.