title: Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction: Case Report and Literature Review.
abstract: Ruptured mycotic aneurysms occur infrequently in current clinical practice, and a pneumococcal etiology is even more rare. This case report describes a patient who initially presented with catheter lab activation for an acute ST-elevation myocardial infarction, receiving a full Plavix load. She was subsequently found to have a ruptured aortic aneurysm and underwent emergency surgical repair, with intraoperative findings of an aorta seeded with Streptococcus pneumonia. A retrospective evaluation of her history revealed clues of a previous upper respiratory infection and long-standing back pain. The subsequent literature review summarizes presentations and outcomes in previously reported, ruptured pneumococcal aneurysms and describes the relatively common occurrence of aortic conditions masquerading as acute myocardial infarctions. We provide recommendations to help approach similar situations in the future.
authors.affiliation: Bonde Artificial Heart Laboratory, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Xiaoyue Mona
authors.initials: XM
authors.lastname: Guo
authors.affiliation: Section of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Pramod
authors.initials: P
authors.lastname: Bonde
keywords: Aneurysm; Mycotic; Rupture; STEMI; Streptococcal