Khan Safi U, Lone Ahmad N, Subramanian Charumathi Raghu, DePersis Michael, Sporn Daniel
Guthrie Clinic/Robert Packer Hospital, Sayre, PA, 18850.
Guthrie Clinic/Robert Packer Hospital, Sayre, PA, 18850.
Cardiovasc Revasc Med. 2017 Sep;18(6S1):19-22. doi: 10.1016/j.carrev.2017.03.005. Epub 2017 Mar 7.
Acute myocardial infarction (MI) in the setting of infective endocarditis (IE) of mechanical cardiac valve is a rare phenomenon. The most challenging aspect is the recognition between septic embolus versus thromboembolism from prosthesis in the setting of sub-therapeutic INR especially when the coronary vasculature is normal and etiology is not clear. We are presenting a case of 56-year-old patient who developed ST elevation MI during treatment of IE of mechanical aortic valve. Cardiac catheterization showed a very subtle blockade at most distal end of LAD therefore percutaneous coronary intervention (PCI) could not be carried out. Given the lack of clear etiology between septic embolus versus prosthesis associated thromboembolism, we opted for a successful conservative approach.
机械心脏瓣膜感染性心内膜炎（IE）背景下的急性心肌梗死（MI）是一种罕见现象。最具挑战性的方面是在国际标准化比值（INR）未达治疗水平的情况下，鉴别感染性栓子与人工瓣膜血栓栓塞，尤其是当冠状动脉血管正常且病因不明时。我们报告一例56岁患者，在机械主动脉瓣IE治疗期间发生ST段抬高型心肌梗死。心脏导管检查显示在左前降支（LAD）最远端有非常细微的阻塞，因此无法进行经皮冠状动脉介入治疗（PCI）。鉴于感染性栓子与人工瓣膜相关血栓栓塞之间缺乏明确病因，我们选择了成功的保守治疗方法。
