Mitral Valve Infective Endocarditis Complicated With Coronary Artery Embolization

Abstract

Infective endocarditis is a multisystem and potentially fatal disease. Systemic embolization is a relatively common complication, the spleen and central nervous system being the most frequent sites for septic emboli formation. Coronary artery septic embolization is extremely uncommon and its management remains controversial.We present the case of a 50-year-old male diagnosed with mitral valve infective endocarditis complicated with spleen and central nervous system embolization, who developed acute myocardial infarction two weeks after disease onset. The patient was successfully treated with combined mitral valve replacement and coronary artery bypass grafting.

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

“…ACS that complicates infectious endocarditis is a rare complication, with an incidence of 2.9% and a mortality rate which can reach up to 64% [ 29 , 31 ]. Usually, coronary embolism occurs in the first 15 days of the disease [ 35 ]. Our literature review indicates that, in patients with large vegetations and prosthetic valves, embolic phenomena are often recurrent.…”

“…3.1.5. Embolic Events from Endocarditis on the Right-Side Valves IE on the right side is more commonly associated with IVDA, intravenous catheters, and intracardiac devices [20,35].…”

“…The subsequent evolution was favorable under a treatment with ceftriaxone and ampicillin. Subsequently, after four weeks of combined treatment with ampicillin and ceftriaxone, the patient was discharged, with the recommendation to continue linezolid treatment for another two weeks to complete six weeks of antimicrobial therapy [ 35 ].…”

Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction

“…Another concern was the timing of the surgery. Recent studies have shown better outcomes with early surgery (within three days of brain infarction) than delayed surgery [ 1 ]. However, in the current case, we performed the surgery six days after the brain infarction, which resulted in no exacerbation.…”

“…Infective endocarditis (IE) is a devastating disease caused by Staphylococcus aureus . IE occurs in approximately 3-10/100,000 people [ 1 ]. Its predisposing risk factors include intravenous drug use, valve prolapse, prosthetic valve replacement, intracardiac defects, and hemodialysis.…”