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Case Reports
. 2016 Jun;8(6):259-62.
doi: 10.4103/1947-2714.185040.

Prosthetic Aortic Valve Endocarditis with Left Main Coronary Artery Embolism: A Case Report and Review of the Literature

Hafeez Ul Hassan Virk  1 , Faisal Inayat  2 , Salman Farooq  3 , Ali Raza Ghani  4 , Ghazi A Mirrani  5 , Muhammed Waqas Athar  6
Affiliations
Case Reports

Prosthetic Aortic Valve Endocarditis with Left Main Coronary Artery Embolism: A Case Report and Review of the Literature

Hafeez Ul Hassan Virk et al. N Am J Med Sci. 2016 Jun.

Abstract

Context: Coronary embolization is potentially a fatal sequela of endocarditis. Although the primary cause of acute coronary syndrome is atherosclerotic disease, it is imperative to consider septic embolism as an etiological factor.

Case report: Herein, we report a case of ventricular fibrillation and ST-segment depression myocardial infarction occurring in a patient who initially presented with fever and increased urinary frequency. Coronary angiography revealed new 99% occlusion of the left main coronary artery (LMCA). Transesophageal echocardiography showed bioprosthetic aortic valve with an abscess and vegetation. Histologic examination of the embolectomy specimen confirmed the presence of thrombus and Enterococcus faecalis bacteria. Subsequently, the patient was discharged to the skilled nursing facility in a stable condition where he completed 6 weeks of intravenous ampicillin.

Conclusion: We present a rare case of LMCA embolism due to prosthetic valve endocarditis. The present report also highlights the diagnostic and therapeutic challenges associated with such patients.

Keywords: Coronary artery embolism; enterococcus faecalis; myocardial infarction; prosthetic aortic valve endocarditis.

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Figures

Figure 1
Figure 1
Electrocardiogram demonstrating atrial fibrillation with rapid ventricular response and ST-depressions in leads II, aVF, and V2–V6
See this image and copyright information in PMC

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