Acute on Chronic Limb-Threatening Ischemia Associated with Septic Embolism in Patient with Infective Endocarditis

Ati, Nindya Sari Diajeng Laras; Subagjo, Agus; Muhammad, Rizal; Aditya, Muhammad

doi:10.47144/phj.v56i1.2408

Cited by 1 publication

(1 citation statement)

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“…Because it causes vascular occlusion, a septic embolism can lead to various degrees of ischemia in the area supplied by the occluded vessel. Most often, systemic embolization occurs in IE, affecting the valves on the left side of the heart, and can lead to stroke, splenic infarction, renal infarction, limb ischemia, or acute myocardial infarction if septic emboli occlude coronary arteries [ 9 ]. Less common in terms of IE complications, but increasingly recognized, acute myocardial infarction (AMI) has a variable incidence, between 1 and 10%.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Perspectives of Challenges in Infective Endocarditis Complicated by Septic Embolic-Induced Acute Myocardial Infarction

Stamate,

Ciobotaru,

Arbune

et al. 2024

Antibiotics

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Background: Infective endocarditis (IE) management is challenging, usually requiring multidisciplinary collaboration from cardiologists, infectious disease specialists, interventional cardiologists, and cardiovascular surgeons, as more than half of the cases will require surgical procedures. Therefore, it is essential for all healthcare providers involved in managing IE to understand the disease’s characteristics, potential complications, and treatment options. While systemic embolization is one of the most frequent complications of IE, the coronary localization of emboli causing acute myocardial infarction (AMI) is less common, with an incidence ranging from 1% to 10% of cases, but it has a much higher rate of morbidity and mortality. There are no guidelines for this type of AMI management in IE. Methods: This narrative review summarizes the current knowledge regarding septic coronary embolization in patients with IE. Additionally, this paper highlights the diagnosis and management challenges in such cases, particularly due to the lack of protocols or consensus in the field. Results: Data extracted from case reports indicate that septic coronary embolization often occurs within the first two weeks of the disease. The aortic valve is most commonly involved with vegetation, and the occluded vessel is frequently the left anterior descending artery. Broad-spectrum antibiotic therapy followed by targeted antibiotic therapy for infection control is essential, and surgical treatment offers promising results through surgical embolectomy, concomitant with valve replacement or aspiration thrombectomy, with or without subsequent stent insertion. Thrombolytics are to be avoided due to the increased risk of bleeding. Conclusions: All these aspects should constitute future lines of research, allowing the integration of all current knowledge from multidisciplinary team studies on larger patient cohorts and, subsequently, creating a consensus for assessing the risk and guiding the management of this potentially fatal complication.

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Section: Introductionmentioning

confidence: 99%