Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Feb 1;3(1):30-7.
doi: 10.12945/j.aorta.2015.14-051. eCollection 2015 Feb.

Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction: Case Report and Literature Review

Xiaoyue Mona Guo  1 , Pramod Bonde  2
Affiliations
Case Reports

Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction: Case Report and Literature Review

Xiaoyue Mona Guo et al. Aorta (Stamford). .

Abstract

Ruptured mycotic aneurysms occur infrequently in current clinical practice, and a pneumococcal etiology is even more rare. This case report describes a patient who initially presented with catheter lab activation for an acute ST-elevation myocardial infarction, receiving a full Plavix load. She was subsequently found to have a ruptured aortic aneurysm and underwent emergency surgical repair, with intraoperative findings of an aorta seeded with Streptococcus pneumonia. A retrospective evaluation of her history revealed clues of a previous upper respiratory infection and long-standing back pain. The subsequent literature review summarizes presentations and outcomes in previously reported, ruptured pneumococcal aneurysms and describes the relatively common occurrence of aortic conditions masquerading as acute myocardial infarctions. We provide recommendations to help approach similar situations in the future.

Keywords: Aneurysm; Mycotic; Rupture; STEMI; Streptococcal.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Chest plain film revealed new widening of the mediastinum (B, double-headed arrow) compared to three weeks prior (A).
Figure 2.
Figure 2.
Emergency CTA showed a 5.2cm by 4.2cm pseudoaneurysm (*) arising at the origin of the common trunk of the right brachiocephalic and left common carotid arteries.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. McNamara RL, Wang YF, Herrin J, Curtis JP, Bradley EH, Magid DJ, et al. Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2006;47:2180–2186. DOI: 10.1016/j.jacc.2005.12.072 - DOI - PubMed
    1. Ting HH, Krumholz HM, Bradley EH, Cone DC, Curtis JP, Drew BJ, et al. Implementation and integration of prehospital ECGs Into Systems of Care for Acute Coronary Syndrome: A Scientific Statement From the American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research, Emergency Cardiovascular Care Committee, Council on Cardiovascular Nursing, and Council on Clinical Cardiology. Circulation. 2008;118:1066–1079. DOI: 10.1161/circulationaha.108.190402 - DOI - PubMed
    1. Gu YL, Svilaas T, van der Horst ICC, Zijlstra F. Conditions mimicking acute ST-segment elevation myocardial infarction in patients referred for primary percutaneous coronary intervention. Neth Heart J. 2008;16:325–331. DOI: 10.1007/BF03086173 - DOI - PMC - PubMed
    1. Chan FY, Crawford ES, Coselli JS, Safi HJ, Williams TW Jr. In situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann Thorac Surg. 1989;47:193–203. DOI: 10.1016/0003-4975(89)90268-3 - DOI - PubMed
    1. Grandmougin D, Warembourg H, Fayad G. Successful treatment of primary pneumococcal multilocular mycotic aneurysms. Eur J Cardio-Thorac. 1997;12:133–137. DOI: 10.1016/s1010-7940(97)00125-5 - DOI - PubMed

Publication types