ISSN : 2146-3123
E-ISSN : 2146-3131

A Coronary Septic Embolism in Double Prosthetic Valve Endocarditis Presenting as Acute Anteroseptal ST-Segment-Elevation Myocardial Infarction
Nazmi Gültekin 1, Gülsüm Bulut 1, Emine Küçükateş 2
1Department of Cardiology, İstanbul University Cardiology Institute, İstanbul, Turkey
2Laboratory of Microbiology and Clinical Microbiology, İstanbul University Cardiology Institute, İstanbul, Turkey
DOI : 10.5152/balkanmedj.2012.063
Pages : 328-330

Abstract

Acute myocardial infarction caused by septic embolism is usually fatal. A 40-year-old male patient who presented within 30 minutes of severe chest pain was admitted to the emergency department. An electrocardiogram showed a maximum 6 mm of acute ST elevations at V1-V4 derivations. His body temperature was as high as 38.5ºC. Blood cultures were taken three times before parenteral ampicillin/ sulbactam treatment was administered. Later, coagulase negative staphylococci (Methicillin Sensitive Staphylococcus epidermidis) were identified from his blood cultures. Coronary angiographic examination was performed. Lobulated contours of a septic embolus was shown in the mid region of left anterior descending artery as an outcome. Trans-esophageal echocardiography  showed; mobile multiple vegetations on the prosthetic mitral and aorta valves. After six weeks of antibiotherapy, he was completely healed and discharged from hospital.Six months later, he was rehospitalized and died because of complications of recurrent infective endocarditis.

Keywords : Infective endocarditis, prosthetic valve, coronary septic embolism, myocardial infarction, trans-esophageal echocardiography

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