Infective Endocarditis with an Infectious Cerebral Aneurysm Rupture and an Acute Myocardial Infarction

Kunitaka Kumagai＊

Shingo Ishiguro＊

（Department of Cardiovascular Surgery, National Hospital Organization Hamada Medical Center＊, Hamada, Japan）

A 56-year-old woman was referred to our hospital due to anorexia. An echocardiogram demonstrated severe mitral valve regurgitation and vegetation located on the valve. We diagnosed infective endocarditis and started to treat with antibiotics. During antibiotics treatment, cerebral hemorrhage was caused by rupture of an infectious cerebral aneurysm. She was treated by surgical operation. Waiting for cardiac surgery, she had sudden chest pain. Electrocardiogram examination demonstrated an anterior acute myocardial infarction. Emergency coronary angiogram revealed complete obstruction of the left anterior descending coronary artery. She was successfully treated with thrombus aspiration using a catheter device and stenting. However, she was in cardiogenic shock and her blood pressure could not be maintained with catecholamine and IABP. We performed emergency mitral valve replacement. After surgery, the circulation dynamics improved and she was discharged from the hospital.

 

Jpn. J. Cardiovasc. Surg. 49:200-204（2020）

Keywords：infective endocarditis;coronary obstruction;rupture of an infectious cerebral aneurysm;mitral valve replacement