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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.

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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

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