Korean Circ J.  2002 May;32(5):433-437. 10.4070/kcj.2002.32.5.433.

A Case of Acute Myocardial Infarction due to Coronary Microembolism in Bacterial Endocarditis

• Kim NH
• Lee BH
• Lee CK
• Sohn IS
• Kang IK
• Lee G
• Lee SJ
• Kim JH
• Choi RK
• Hwang HK

• KMID: 2227272
• DOI: http://doi.org/10.4070/kcj.2002.32.5.433

Abstract

Spontaneous coronary artery embolization is a known complication of infective endocarditis. However, a microembolism from the aortic valve into the left anterior descending artery resulting in an acute anterior myocardial infarction is very rare. A 44-year-old male patient suffered from chest pain and fever of seven days duration. The echocardiogram demonstrated severe aortic stenosis, aortic root abscess and mobile vegetation on bicuspid aortic valve near the left coronary artery ostium. The electrocardiogram revealed ST segment elevation in lead V1-3 and heart enzyme analysis showed LD 936 IU/L, CK 299 IU/L, CK-MB 7.2 U/L, Troponin I 9.94 ng/mL. Diagnostic coronary angiogram revealed insignificant coronary lesion. Emergent operation was required because of aortic root abscess formation and high risk of recurrent embolization. He underwent surgery for aortic valve replacement and conservative management for acute myocardial infarction. The purpose of this article is to report the successful emergent aortic valve replacement of a patient with myocardial infarction due to coronary microembolism in a case of bacterial endocarditis.

Keyword

Endocarditis bacterial; Myocardial infarction

MeSH Terms

Abscess
Adult
Aortic Valve
Aortic Valve Stenosis
Arteries
Bicuspid
Chest Pain
Coronary Vessels
Electrocardiography
Endocarditis
Endocarditis, Bacterial*
Fever
Heart
Humans
Male
Myocardial Infarction*
Troponin I
Troponin I