Coronary events complicating infective endocarditis

Roux, V.; Salaün, Erwan; Tribouilloy, Christophe; Hubert, Sandrine; Bohbot, Yohann; Casalta, Jean‐Paul; Barral, Pierre-Antoine; Ruşinaru, Dan; Gouriet, Frédérique; Lavoûte, Cécile; Haentjens, Julie; Biscegli, Mathieu Di; Dehaene, A.; Renard, Sébastien; Casalta, Anne-Claire; Pradier, J.; Avierinos, Jean-François; Ribéri, Alberto; Lambert, Marc; Collart, Frédéric; Jacquier, Alexis; Thuny, Franck; Camoin-Jau, Laurence; Lépidi, Hubert; Raoult, Didier; Habib, Gilbert

doi:10.1136/heartjnl-2017-311624

Cited by 37 publications

(56 citation statements)

References 18 publications

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“…In a study by Tiurin et al of 104 patients with infective endocarditis in which 11 had ACS, one was noted on autopsy to have a vegetation covering the left main coronary ostium on a native aortic valve [11]. In the study by Roux et al [2], one case of ACS in the cohort was caused by obstruction of the left main coronary ostium by a vegetation in a patient with a bioprosthetic aortic valve. Since these two cases are reported as part of larger cohorts of infective endocarditis patients, there are no specific clinical nor microbiologic data available to help guide clinicians on patients susceptible to this complication.…”

Section: Discussionmentioning

confidence: 99%

“…A transesophageal echocardiogram was then obtained, demonstrating a mobile 2.7 cm density attached to the right coronary cusp of the aortic valve that was intermittently prolapsing into the right coronary ostium (Fig. 3, see also Additional files [1][2][3]. No wall motion abnormalities were noted.…”

Section: Case Presentationmentioning

confidence: 99%

“…More recently, a French cohort of 1210 patients with infective endocarditis demonstrated 26 cases (2.2%) of ACS complicating care, with 7 deaths [2]. In these studies, the most common causes of ACS were septic embolization into the affected coronary artery [2], or external compression of the coronary artery by an abscess [1]. This is reflected in multiple case reports published on this topic [3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…A seldom documented cause of ACS in infective endocarditis is mechanical obstruction of a coronary artery by a vegetation [2,11]. We present a case of ST elevation myocardial infarction due to occlusion of the right coronary ostium.…”

Section: Introductionmentioning

confidence: 99%

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ST segment elevation caused by ostial right coronary artery obstruction in infective endocarditis: a case report

Bolton

Hajj

Payvandi

et al. 2020

BMC Cardiovasc Disord

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Background Acute coronary syndrome (ACS) is a rare, but serious complication of infective endocarditis, and diagnosis can be challenging given clinical overlap with other syndromes. A rare cause of ACS in infective endocarditis is mechanical obstruction of the coronary artery. We present the case of a patient with infective endocarditis who developed ST segment myocardial infarction due to occlusion of the right coronary artery ostium by a vegetation. Case presentation A 53-year-old female with no prior history of coronary artery disease was transferred to our tertiary care facility for evaluation and treatment of suspected myopericarditis. After transfer she developed inferior ST segment elevations on ECG along with fever and positive blood cultures for methicillin susceptible Staphylococcus aureus (MSSA). A transesophageal echocardiogram revealed a vegetation on the aortic valve that intermittently prolapsed into the right coronary ostium. She decompensated from a hemorrhagic brain infarct and subsequently transferred to the intensive care unit. She underwent surgical aortic valve debridement without prior cardiac catheterization given the danger of septic coronary embolization. After a prolonged hospital course with multiple complications, she was able to discharge home, with no neurologic deficits on follow-up. Conclusions ACS presents a diagnostic and therapeutic challenge in the setting of infective endocarditis. Careful attention to the history, physical exam and testing can help differentiate infective endocarditis from other conditions sharing similar symptoms. Traditional atherosclerotic ACS management may cause great harm when treating patients with infective endocarditis. The presence of a multidisciplinary endocarditis team is ideal to provide the best clinical outcomes for this population.

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Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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ST segment elevation caused by ostial right coronary artery obstruction in infective endocarditis: a case report

Bolton

Hajj

Payvandi

et al. 2020

BMC Cardiovasc Disord

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“…Coronary embolic events are rare. In a series of 1210 patient with endocarditis, Roux et al found only 26 (2.2%) patients had an acute coronary syndrome (7). The majority of cases (88%) were due to coronary embolism.…”

mentioning

confidence: 98%

Timing of surgery after secondary embolic events in infective endocarditis

2019

Ann. Cardiothorac. Surg.

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Acute heart failure and valvular heart disease: A scientific statement of the Heart Failure Association, the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the European Society of Cardiology

Chioncel

Adamo

Nikolaou³

et al. 2023

European J of Heart Fail

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Acute heart failure (AHF) represents a broad spectrum of disease states, resulting from the interaction between an acute precipitant and a patient's underlying cardiac substrate and comorbidities. Valvular heart disease (VHD) is frequently associated with AHF. AHF may result from several precipitants that add an acute haemodynamic stress superimposed on a chronic valvular lesion or may occur as a consequence of a new significant valvular lesion. Regardless of the mechanism, clinical presentation may vary from acute decompensated heart failure to cardiogenic shock. Assessing the severity of VHD as well as the correlation between VHD severity and symptoms may be difficult in patients with AHF because of the rapid variation in loading conditions, concomitant destabilization of the associated comorbidities and the presence of combined valvular lesions. Evidence‐based interventions targeting VHD in settings of AHF have yet to be identified, as patients with severe VHD are often excluded from randomized trials in AHF, so results from these trials do not generalize to those with VHD. Furthermore, there are not rigorously conducted randomized controlled trials in the setting of VHD and AHF, most of the data coming from observational studies. Thus, distinct to chronic settings, current guidelines are very elusive when patients with severe VHD present with AHF, and a clear‐cut strategy could not be yet defined. Given the paucity of evidence in this subset of AHF patients, the aim of this scientific statement is to describe the epidemiology, pathophysiology, and overall treatment approach for patients with VHD who present with AHF.

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Coronary events complicating infective endocarditis

Abstract: ACS is a rare complication of IE but is associated with an increased risk of heart failure and high mortality rate.

Cited by 37 publications

References 18 publications

ST segment elevation caused by ostial right coronary artery obstruction in infective endocarditis: a case report

ST segment elevation caused by ostial right coronary artery obstruction in infective endocarditis: a case report

Timing of surgery after secondary embolic events in infective endocarditis

Acute heart failure and valvular heart disease: A scientific statement of the Heart Failure Association, the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the European Society of Cardiology

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