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感染性主动脉瓣心内膜炎导致栓塞性连续性ST段抬高型心肌梗死

Infective Aortic Valve Endocarditis Causing Embolic Consecutive ST-Elevation Myocardial Infarctions.

作者信息

Peddi Kanksha, Hsu Alexander L, Ayala Tomas H

机构信息

Saba University School of Medicine, Saba, Dutch Caribbean, Netherlands.

Department of Medicine, MedStar Harbor Hospital, Baltimore, MD, USA.

出版信息

Case Rep Cardiol. 2019 Oct 14;2019:2487616. doi: 10.1155/2019/2487616. eCollection 2019.

Abstract

ST-elevation myocardial infarction (STEMI) is a rare and potentially fatal complication of infective endocarditis. We report the ninth case of embolic native aortic valve infective endocarditis causing STEMI and the first case to describe consecutive embolisms leading to infarctions of separate coronary territories. Through examination of this case in the context of the previous eight similar documented cases in the past, we find that infective endocarditis of the aortic valve can and frequently affect more than a single myocardial territory and can occur consecutively. Further, current treatment modalities for embolic infective endocarditis causing acute myocardial infarction are limited and unproven. This index case illustrates the potential severity of complications and the challenges in developing standardized management for such patients.

摘要

ST段抬高型心肌梗死(STEMI)是感染性心内膜炎一种罕见且可能致命的并发症。我们报告了第九例由栓塞性自体主动脉瓣感染性心内膜炎导致STEMI的病例,也是首例描述连续栓塞导致不同冠状动脉区域梗死的病例。通过结合过去八例类似的已记录病例来分析此病例,我们发现主动脉瓣感染性心内膜炎能够且经常累及不止一个心肌区域,并且可能连续发生。此外,目前针对导致急性心肌梗死的栓塞性感染性心内膜炎的治疗方式有限且未经证实。该索引病例说明了并发症的潜在严重性以及为这类患者制定标准化管理方案所面临的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e31b/6815559/f2e36e582b7f/CRIC2019-2487616.001.jpg

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