Jose John, Narayanan Kumar, Chacko Sujith Thomas, George Oommen K
Department of Cardiology, Christian Medical College Hospital, Vellore, India.
J Heart Valve Dis. 2011 Jul;20(4):468-70.
Despite diagnostic and therapeutic advances, mortality and morbidity associated with infective endocarditis (IE) remains high. Congestive heart failure and complications such as septic embolization and aortic root abscess are the main causes. Although aortic root abscess is a common complication of IE involving the aortic valve, acute myocardial infarction (AMI) is a rare complication in patients with endocarditis, whether in the acute or later phase of infection. In most cases, the infarction is either anterior or anterolateral. To the best of the present authors' knowledge, only one case of infarction at a purely inferior site has been reported previously. In the present case, IE with an aortic root abscess presented clinically as an acute inferior wall myocardial infarction.
尽管在诊断和治疗方面取得了进展,但感染性心内膜炎(IE)相关的死亡率和发病率仍然很高。充血性心力衰竭以及脓毒性栓塞和主动脉根部脓肿等并发症是主要原因。虽然主动脉根部脓肿是累及主动脉瓣的IE的常见并发症,但急性心肌梗死(AMI)在感染性心内膜炎患者中无论是在感染的急性期还是后期都是罕见的并发症。在大多数情况下,梗死部位为前壁或前侧壁。据作者所知,此前仅报道过一例梗死部位为单纯下壁的病例。在本病例中,伴有主动脉根部脓肿的IE临床上表现为急性下壁心肌梗死。