Korean J Leg Med.  2021 Nov;45(4):122-126. 10.7580/kjlm.2021.45.4.122.

Sudden Cardiac Death Caused by a Septic Coronary Artery Embolism as the First Clinical Presentation of Infective Endocarditis

Affiliations
  • 1Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Hyundai Forensic Medical Service, Seoul, Korea
  • 3Division of Forensic Medical Examination, National Forensic Service, Wonju, Korea
  • 4Division of Forensic Investigation, National Forensic Service, Wonju, Korea

Abstract

This report describes an uncommon and fatal case of myocardial infarction due to coronary embolus arising from vegetation in the aortic valve with a background of infective endocarditis (IE). There are various causes of fatal IE. Myocardial infarction due to septic emboli is rare. We report a case of sudden death in a 69-year-old woman with hyperlipidemia and no known cardiac disease. She had severe general weakness and was hospitalized for colonoscopy. The patient unexpectedly presented with cardiac arrest and died. The autopsy showed total occlusion of the left anterior descending artery by an embolus, which originated from the septic vegetation of the aortic valve. Myocardial infarction from septic emboli associated with IE can be fatal and manifested as the first presentation. In autopsy practice of deceased patients with IE, careful examination of the coronary arteries is required.

Keyword

Autopsy; Infective endocarditis; Vegetation; Myocardial infarction
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