Related Experiment Video
Updated: Aug 30, 2026

Visualization of Streptococcus pneumoniae within Cardiac Microlesions and Subsequent Cardiac Remodeling
Published on: April 7, 2015
Silent Cardiac Rupture Unmasked by Routine Echocardiography During Persistent Staphylococcus aureus Bacteremia
David Neuhalfen1, Pablo Dominguez-Erquicia1, Ana Ledo-Piñeiro1
1Department of Cardiology, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain; Instituto de Investigación Biomédica Galicia Sur, Vigo, Pontevedra, España.
Background:
Postinfarction mechanical complications are rare in the primary percutaneous coronary intervention era. We report a silent, contained left ventricular free wall rupture driven by persistent staphylococcal bacteremia in an immunomodulated patient.
Case Summary:
A 64-year-old man with active ulcerative colitis on corticosteroids and vedolizumab presented with an anterior ST-segment elevation myocardial infarction, complicated by early stent thrombosis. He developed persistent Staphylococcus aureus bacteremia; transesophageal echocardiography excluded endocarditis. Although clinically stable, routine echocardiography on postinfarction day 24 detected a silent contained free wall rupture. Surgery revealed hemato-purulent pericardial effusion with culture-confirmed Saureus. After initial recovery, a ventricular septal defect developed, requiring percutaneous closure. The patient died 2 months postinfarction.
Discussion:
To our knowledge, this is the first antemortem diagnosis of sequential postinfarction mechanical complications driven by confirmed staphylococcal infection of necrotic myocardium without endocarditis.
Take-Home Messages:
Persistent Saureus bacteremia after infarction warrants comprehensive evaluation beyond endocarditis. Structured echocardiographic surveillance can detect silently evolving mechanical complications.
Related Concept Videos
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Rheumatic Heart Disease I: Introduction
Cardiovascular System Abnormal Findings II: Auscultation
Abnormal Heart Sounds
Gallops:
Mitral Stenosis II: Clinical features and Diagnostic Tests
Acute Coronary Syndrome I: Introduction
Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...
