Author + information
- Minar Chhetry,
- Mandeep Kainth,
- Gregory Gustafson and
- Janine Harewood
Myocardial infarction (MI) from Infective Endocarditis (IE) is a rare occurrence. We report a case of MI with emergent catheterization revealed findings suggestive of coronary embolism. He was positive for MSSA (Methicillin Susceptible Staphylococcus Aureus) in his blood cultures and embolic aspirate.
58 year old with history of intermittent hematuria presented with chest pain. His Electrocardiogram showed ST elevations with elevated CK and troponin. He was given aspirin and Nitroglycerin. He was emergently taken for cardiac catheterization, found to have a left coronary (distal) vessel embolic occlusion of the first diagonal and the second obtuse marginal. Meanwhile, blood cultures obtained on presentation were positive for MSSA. He was diagnosed with IE and resultant coronary occlusion causing MI.
Coronary emboli from IE do occur and can present as ST-elevation MI. Septic coronary embolism was first established through autopsy studies in patients with IE. The incidence was reported in one study to be 2.9% with a 64% mortality rate.
MI can occur in early acute phase of IE. Main options for restoring the coronary reperfusion, are the use of thrombolytic, intracoronary stent, percutaneous transluminal coronary angioplasty aspiration catheter, and surgical embolectomy. Trials such as TAPAS has shown that aspiration thrombectomy have shown better ST- segment elevation resolution, and improved TIMI flow.
Poster Hall, Hall A/B
Saturday, March 10, 2018, 10:00 a.m.-10:45 a.m.
Session Title: FIT Clinical Decision Making: Interventional Cardiology, Ischemic Heart Disease and Vascular Medicine
Abstract Category: Interventional Cardiology
Presentation Number: 1108-116
- 2018 American College of Cardiology Foundation