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Isolated myocardial abscess causing coronary artery rupture and fatal hemopericardium
C C Fan1, B R Andersen, S Sahgal
1Department of Pathology, University of Illinois, Chicago 60612.
Insights
A rare case of sudden death in a 46-year-old man was caused by cardiac tamponade. This resulted from a myocardial abscess rupturing a coronary artery, leading to hemopericardium.
Area of Science:
- Cardiology
- Pathology
- Infectious Diseases
Background:
- Myocardial abscesses are rare cardiac infections.
- Cardiac tamponade is a life-threatening condition caused by fluid accumulation in the pericardium.
Observation:
- A solitary myocardial abscess led to erosion and rupture of an adjacent coronary artery.
- This resulted in hemopericardium (blood in the pericardial sac).
Findings:
- The patient experienced sudden death due to the resulting cardiac tamponade.
- Staphylococcus aureus was identified as the causative agent of the myocardial abscess.
Implications:
- This case highlights a rare but fatal complication of myocardial abscesses.
- Coronary artery rupture secondary to myocardial abscess is an extremely infrequent event.
Abstract:
We report a rare case of cardiac tamponade caused by hemopericardium secondary to erosion and rupture of a coronary artery by an adjacent solitary myocardial abscess. The resulting tamponade led to the sudden death of this 46-year-old man. Antemortem blood culture and the postmortem microscopic examination of the myocardial abscess revealed the causative agent to be Staphylococcus aureus. Hemopericardium due to ventricular wall rupture secondary to a myocardial abscess has been infrequently reported, but, to our knowledge, only one other report of hemopericardium due to coronary artery rupture related to myocardial abscess has been published.