title: Septic coronary embolism in aortic valvular endocarditis.
abstract: Acute myocardial infarction due to septic coronary emboli in active infective endocarditis is rare, but may be fatal. The case is reported of a 58-year-old man who presented with wrist arthritis, which resulted in acute aortic valvular endocarditis. Echocardiography revealed 3 mm vegetations on the posterior and anterior valve cusps, and aortic regurgitation (grade 3-4). As the patient's clinical status was stable, medical treatment was selected which included antibiotic therapy, but after four weeks the patient reported an acute anterior chest pain. Coronary angiography revealed stenosis of the left anterior descending (LAD) artery, due to septic embolism. The patient was referred for emergency cardiac surgery, at which a surgical thrombectomy and coronary artery bypass grafting with reconstruction of the LAD artery were performed, along with aortic valve replacement using a bioprosthesis. The postoperative course was uneventful and the patient was discharged on postoperative day 15. An adapted oral antibiotherapy was continued for a further six-week period.
authors.affiliation: Department of Anesthesiology, South Hospital, Laennec avenue 80054, Amiens, Salouel, France.
authors.forename: Anitha
authors.initials: A
authors.lastname: Kessavane
authors.forename: Paul
authors.initials: P
authors.lastname: Marticho
authors.forename: Elie
authors.initials: E
authors.lastname: Zogheib
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lorne
authors.forename: Hervé
authors.initials: H
authors.lastname: Dupont
authors.forename: Christophe
authors.initials: C
authors.lastname: Tribouilloy
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Remadi
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001021:Aortic Valve / Q000382:microbiology / Q000601:surgery; D001170:Arthritis, Infectious / Q000150:complications*; D023921:Coronary Stenosis / Q000209:etiology; D003328:Coronary Thrombosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D017131:Thrombectomy; D014955:Wrist Joint
chemical_list: D000900:Anti-Bacterial Agents