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Native Aortic and Tricuspid Valve Endocarditis Complicated by Embolic ST Elevation Myocardial Infarction
Journal article   Open access   Peer reviewed

Native Aortic and Tricuspid Valve Endocarditis Complicated by Embolic ST Elevation Myocardial Infarction

Mumtaz Zaman, Richard Loynd and Anthony Donato
Case reports in cardiology, v 2019(2019), pp 1-6
01 Jan 2019
PMID: 30944741
url
https://doi.org/10.1155/2019/1348607View
Published, Version of Record (VoR) Open

Abstract

Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology
Acute myocardial infarction due to a coronary embolic event can occur as a complication of infective endocarditis in up to 2.9% of cases and can frequently be the presenting symptom. A 35-year-old female presented with 4 hours of typical chest pain and was found to have ST elevations in inferior leads as well as an elevated serum Troponin I of 8.29 ng/ml (normal: <0.06 ng/ml). Urgent cardiac catheterization revealed total occlusion of the right coronary artery without other coronary disease or collaterals. Following a failed attempt at thrombus extraction, a 3.0x38mm bioabsorbable drug-eluting stent was placed. Echocardiography then revealed large mobile aortic valve vegetations with the largest measuring 1.4x1.7cm, severe tricuspid regurgitation with a 1.1x0.5cm mobile vegetation on the anterior leaflet along with a patent foramen ovale with right-to-left shunting. Blood cultures identified Enterococcus faecalis in 4 of 4 vials. The patient underwent urgent replacement of tricuspid and aortic valves as well as 6 weeks of IV antibiotics followed by chronic antibiotic suppression.

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Cardiac & Cardiovascular Systems
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