Infective endocarditis causing acute myocardial infarction by compression of the proximal left coronary artery due to a mycotic aneurysm of the sinus of valsalva.

Koike, Shoichiro; Takayama, Shin; Furihata, Akiko; Furihata, Yasutaka; Sasaki, Yasuyuki; Furuta, Seiichi; Morimoto, Masami

doi:10.1253/jcj.55.1228

Cited by 20 publications

(6 citation statements)

References 8 publications

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“…The reported surgical methods have been the closure of opening of aneurysm with or without aortic valve replacement, repair, or coronary artery bypass grafting 5‐7 . We successfully corrected aneurysm of left sinus of Valsalva with patch closure and aortic valve replacement.…”

Section: Discussionmentioning

confidence: 99%

Acute Myocardial Infarction Due to Unruptured Aneurysm of Left Sinus of Valsalva with Aortic Valve Regurgitation

Shin¹,

Jung²,

Park³

et al. 2005

J Cardiac Surgery

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This report describes a 35-year-old woman with unruptured aneurysm of the left sinus of Valsalva presenting as non-ST elevation myocardial infarction due to the compression of the left coronary artery by aneurysm. Cardiac multislice CT and angiogram revealed a large aneurysm of the left sinus of Valsalva compressing the left main coronary artery. Surgical repair was performed by closing the entrance of the aneurysm and aortic valve replacement. Postoperative coronary flow was restored and thus anginal symptom disappeared.

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Section: Discussionmentioning

confidence: 99%

Acute Myocardial Infarction Due to Unruptured Aneurysm of Left Sinus of Valsalva with Aortic Valve Regurgitation

Shin¹,

Jung²,

Park³

et al. 2005

J Cardiac Surgery

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“…29,31 Compromise of a coronary ostium by a large vegetation or by an expanding mycotic aneurysm has also been reported. 32,33 In this case, the persistently subtherapeutic prothrombin time provides another possible explanation for a postoperative myocardial infarction: thromboembolism from the tissue valve. Without echocardiographic evidence of a wall-motion abnormality or convincing electrocardiographic evidence of serial changes, however, involvement of the large coronary vessels from any cause is unlikely.…”

Section: Differential Diagnosismentioning

confidence: 88%

Case 25-1998

O’Gara¹,

Narula²,

Mark³

1998

N Engl J Med

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A 34-year-old man was admitted to the hospital because of worsening dyspnea and increasing mitral regurgitation after replacement of the aortic valve for acute bacterial endocarditis.The patient had a history of intravenous drug abuse. Four months before admission he had been transferred to this hospital because of acute bacterial endocarditis caused by Staphylococcus aureus, with aortic regurgitation. A test for antibodies to the human immunodeficiency virus was negative. A transesophageal ultrasonographic examination of the heart (Fig. 1) revealed a large prolapsing vegetation on the right coronary cusp of the aortic valve, with severe aortic regurgitation; there was a small mobile vegetation on the septal leaflet, associated with moderate tricuspid regurgitation. Oxacillin, gentamicin, ceftriaxone, and metronidazole were administered.A computed tomographic (CT) scan of the brain showed three enhancing foci, each less than 1 cm in diameter, in the subcortical white matter, a finding consistent with septic embolism. An abdominal CT scan showed multiple splenic infarcts and probable focal infarction or necrosis of an ileal loop, with perforation. The infarcted, perforated segment of terminal ileum and the infarcted spleen were resected, and a pelvic abscess was drained. Subsequently, the aortic valve and a large vegetation were excised (Fig. 2), and a Carpentier-Edwards prosthetic pericardial valve was inserted; an adjacent abscess and a vegetation on the septum near the tricuspid valve were débrided. The patient was discharged, free of symptoms, on the 46th hospital day, after having received oxacillin intravenously for 42 days; warfarin therapy was continued.Five weeks after discharge, a low-grade fever developed, with occasional chest pain, cough, chilliness, sweats, and increasing dyspnea. Clarithromycin was ineffective in treating these symptoms, and after one week the patient returned to the hospital.Examination revealed that the temperature was 37.7°C. The jugular venous pressure was 10 cm, and crackles were heard at both lung bases. A grade 2 systolic murmur was transmitted from the apex to the axilla. The results of a urinalysis were normal. The urea nitrogen and creatinine levels were also normal. The results of other laboratory tests are shown in Tables 1 and 2.

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“…The risk of coronary embolism is increased when the vegetation is mobile, or it is larger than 10 mm, Staphylococcus aureus or streptococcus non viridans streptococcus infections and anterior embolism [ 3 , 4 ].This can be explained by the proximity between aortic vegetations and coronary ostia [ 4 , 5 ]. Coronary extraluminal compression due to coronary mycotic aneurysm or peri-annular aortic complication (abscesses and pseudoaneurysms), which are also described as a mechanism of myocardial ischemia during AR [ 6 ]. Obstruction of the coronary ostium by large vegetation [ 7 ], as in cases of fungal endocarditis with large vegetations.…”

Section: Discussionmentioning

confidence: 99%

Acute coronary syndrome complicating infective endocarditis: A case report with an etiological review

Boulouiz

Bouchlarhem

Amaqdouf

et al. 2022

Annals of Medicine &Amp; Surgery

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Infective endocarditis causing acute myocardial infarction by compression of the proximal left coronary artery due to a mycotic aneurysm of the sinus of valsalva.

Cited by 20 publications

References 8 publications

Acute Myocardial Infarction Due to Unruptured Aneurysm of Left Sinus of Valsalva with Aortic Valve Regurgitation

Acute Myocardial Infarction Due to Unruptured Aneurysm of Left Sinus of Valsalva with Aortic Valve Regurgitation

Case 25-1998

Acute coronary syndrome complicating infective endocarditis: A case report with an etiological review

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