We report a case of ST-elevation myocardial infarction (STEMI) due to septic emboli secondary to endocarditis in a 32-year-old male patient with a past medical history of infectious endocarditis requiring mechanical aortic, mitral and tricuspid valve replacement presented with sharp chest pain and shortness of breath. Electrocardiogram demonstrated an acute inferior STEMI. Coronary angiography revealed occlusion of the terminal left anterior descending (LAD) artery associated with a large apical wrap-around segment exhibiting TIMI 0 flow. Primary angioplasty was not performed given the distal location of the embolus. Clinical suspicion for septic or thrombotic coronary artery embolism was high given the patient's history of mechanical valve prosthesis and in the setting of sub-therapeutic INR. Transesophageal echocardiography revealed a new mobile echodensity on the mitral prosthesis consistent with vegetation. was isolated from blood cultures, confirming the diagnosis of endocarditis. is a rare cause of prosthetic valve endocarditis and should remain in the differential of septic coronary artery embolism among patients with features of infectious endocarditis.
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| http://dx.doi.org/10.7759/cureus.22732 | DOI Listing |
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