title: Infective endocarditis presenting as ST-elevation myocardial infarction: an angiographic diagnosis.
abstract: While systemic embolic events occur with relative frequency in infective endocarditis (IE), coronary embolization remains an uncommon cause of ST elevation myocardial infarction. Herein we report a case of ventricular fibrillation and anterior ST elevation myocardial infarction occurring in a patient initially presenting with septic shock. Angiography proved diagnostic for IE of a native bicuspid aortic valve complicated by root abscess and left anterior descending artery occlusion. Histologic examination of the embolectomy specimen from the left anterior descending artery confirmed the presence of thrombus and bacteria. The present case highlights difficulties in identifying and managing patients with coronary embolism of vegetations from IE.
authors.affiliation: Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hibbert
authors.forename: Mustapha
authors.initials: M
authors.lastname: Kazmi
authors.forename: John P
authors.initials: JP
authors.lastname: Veinot
authors.forename: Edward R
authors.initials: ER
authors.lastname: O'Brien
authors.forename: Christopher
authors.initials: C
authors.lastname: Glover
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000473:pathology; D015906:Angioplasty, Balloon, Coronary; D056988:Anterior Wall Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D004696:Endocarditis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D012815:Signal Processing, Computer-Assisted; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D015607:Stents; D014693:Ventricular Fibrillation / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy