Infective Endocarditis with an Acute Myocardial Infarction

Keisuke Nonoyama＊	Takayuki Saito＊	Yukihide Numata＊
Yuji Yamanaka＊

（Department of Cardiovascular Surgery, Kariya Toyota General Hospital, Kariya, Japan）

An 80-year-old man was referred to our hospital due to anorexia and loss of body weight. Blood examination showed a severe inflammatory reaction and Streptococcus oralis was detected in his blood culture. Echocardiogram demonstrated severe aortic valve regurgitation and vegetation located on the valve. Although we diagnosed infective endocarditis（IE）and started to treat with antibiotics, the patient refused treatment and was discharged. Ten days later, he was readmitted to our hospital because of chest pain. Electrocardiogram demonstrated an anteroseptal acute myocardial infarction and an emergency coronary angiogram revealed complete obstruction of the left anterior descending coronary artery（LAD). He was successfully treated with thrombus aspiration using a catheter device. Pathological examination of the thrombus revealed that the coronary embolism was caused by infective endocarditis（IE). To prevent re-embolization, we performed aortic valve replacement 8 days after the intervention and CABG was also carried out for residual stenosis on the LAD. Coronary embolism caused by IE is a rare problem. We reported a case of AMI associated with IE that was initially treated with thrombus aspiration which was followed by aortic valve replacement.

 

Jpn. J. Cardiovasc. Surg. 45:121-125（2016）

Keywords：infective endocarditis;acute myocardial infarction;vegetation