title: Managing embolic myocardial infarction in infective endocarditis: current options.
abstract: Systemic embolization is common in infective endocarditis and is known to occur in 45-65% of cases. Coronary artery embolism has been seen in as many as 60% of cases at necropsy. However, it only rarely has been described as resulting in transmural myocardial infarction. In most cases, coronary embolism is inferred from circumstantial evidence. We present two patients with myocardial infarction in the setting of acute infective endocarditis. Current issues regarding the management of myocardial infarction in infective endocarditis are described in this article. We also describe the first documented case of Lactobacillus jensenii endocarditis leading to myocardial infarction. Possible factors, which may be instrumental in producing endocarditis with this organism, are also discussed.
authors.affiliation: Department of Internal Medicine, Section of Infectious Diseases, West Virginia University Hospitals, Morgantown, West Virginia, USA. fkhan@hsc.wvu.edu
authors.forename: Fida
authors.initials: F
authors.lastname: Khan
authors.forename: Rashida
authors.initials: R
authors.lastname: Khakoo
authors.forename: Conard
authors.initials: C
authors.lastname: Failinger
mesh_terms: D000293:Adolescent; D000328:Adult; D004617:Embolism / Q000209:etiology* / Q000628:therapy*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000382:microbiology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000382:microbiology; D006349:Heart Valve Diseases / Q000150:complications / Q000382:microbiology; D006801:Humans; D007778:Lactobacillus / Q000145:classification; D008297:Male; D008943:Mitral Valve / Q000382:microbiology; D009203:Myocardial Infarction / Q000209:etiology* / Q000628:therapy*; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology; D013211:Staphylococcus aureus; D014261:Tricuspid Valve / Q000382:microbiology