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Embolic myocardial infarction with cardiac arrest as an initial manifestation of non-bacterial thrombotic

Anna C Hansen1, Paramarajan Piranavan2, Amartya Kundu3

  • 1Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA.

BMJ Case Reports
|November 1, 2023
PubMed

Insights

Non-bacterial thrombotic endocarditis, often linked to systemic lupus erythematosus, can rarely cause embolic myocardial infarction. This case highlights ventricular fibrillation arrest due to coronary embolisation in non-bacterial thrombotic endocarditis.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pathology

Background:

  • Non-bacterial thrombotic endocarditis (NBTE) is characterized by sterile vegetations and frequently associated with systemic lupus erythematosus (SLE).
  • NBTE commonly leads to embolic cerebrovascular disease, but cardiac complications like myocardial infarction are exceptionally rare.

Observation:

  • This report details an extremely rare case of embolic myocardial infarction in a patient with NBTE.
  • The patient experienced ventricular fibrillation arrest, presumed to be caused by coronary artery embolisation originating from NBTE.

Findings:

  • The case illustrates a rare embolic myocardial infarction secondary to non-bacterial thrombotic endocarditis.
  • Coronary artery embolisation was the presumed cause of ventricular fibrillation arrest in this patient.

Implications:

  • Management of embolic myocardial infarction in NBTE lacks standardized guidelines and necessitates a tailored, multidisciplinary approach.
  • This case underscores the potential for severe cardiac complications in NBTE, emphasizing the need for heightened clinical awareness and individualized treatment strategies.

Keywords:
Cardiovascular systemInterventional cardiologyMedical educationRheumatology

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