ST-Elevation Myocardial Infarction Associated With Infective Endocarditis

Fatal Embolic ST-Elevation Myocardial Infarction Secondary to Healed-Phase Mitral Valve Infective Endocarditis

“…2,3,5) In addition, most episodes of AMI occur during the acute phase of the infection. 2,4,11) One large prospective observational cohort study found that AMI associated with IE occurred at a mean 17 ± 8 days after the initiation of antibiotic treatments. 2) In the 2015 ESC guidelines for the management of IE, following the initiation of antibiotic therapy, the risk of a new embolism is known to rapidly decrease after 2 weeks.…”

ST-Segment Elevation Myocardial Infarction from Septic Emboli Secondary to Infective Endocarditis by Abiotrophia Defectiva

“…While guidelines for treating infectious endocarditis remain the same [ 8 ], the best practices for management of STEMI in IE are not known, and the data is controversial due to the rarity of cases. Although thrombolytic agents have been used successfully in a few cases, the data militate against the use of such agents due to increased risk of severe intracranial hemorrhage, which is thought to be attributed to the high prevalence of silent cerebral infarctions and mycotic aneurysms [ 10 ]. Despite limited evidence on the efficacy of PCI, there appears to be a trend in using recanalization as a treatment for STEMI in IE.…”

“…It has been reported, however, that balloon inflation at the site of the occlusion might cause a displacement of the vegetation and increase the risk of further embolic phenomena and coronary artery mycotic aneurysms [ 11 ]. Recently, Nazir S et al have reported the success rate of each intervention as follows: 56% in balloon angioplasty, 68% in aspiration thrombectomy, and 81% in coronary stenting [ 10 ].…”

“…Case Reports in Cardiology aneurysms [10]. Despite limited evidence on the efficacy of PCI, there appears to be a trend in using recanalization as a treatment for STEMI in IE.…”

“…It has been reported, however, that balloon inflation at the site of the occlusion might cause a displacement of the vegetation and increase the risk of further embolic phenomena and coronary artery mycotic aneurysms [11]. Recently, Nazir S et al have reported the success rate of each intervention as follows: 56% in balloon angioplasty, 68% in aspiration thrombectomy, and 81% in coronary stenting [10]. Surgery remains indicated in patients who have large vegetations associated with severe valvular disease, those presenting with moderate to severe HF, or in patients with uncontrolled infection.…”