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愈合期二尖瓣感染性心内膜炎致致死性栓塞性 ST 段抬高型心肌梗死。

Fatal Embolic ST-Elevation Myocardial Infarction Secondary to Healed-Phase Mitral Valve Infective Endocarditis.

机构信息

Division of Cardiology, Department of Medicine, Nihon University School of Medicine.

Division of Oncologic Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine.

出版信息

Int Heart J. 2021 Mar 30;62(2):432-436. doi: 10.1536/ihj.20-548. Epub 2021 Mar 17.

Abstract

Embolic myocardial infarction (MI) caused by infective endocarditis (IE) is rare, but it is increasingly recognized as an important complication. This complication typically occurs in patients with aortic valve endocarditis during the acute phase of the infection. It is also known to have a high mortality rate; however, the best practice for its management is unclear owing to scarce available data. In addition, most cases of embolic acute MI (AMI) caused by IE are indirectly diagnosed with a combination of angiographic examination such as coronary angiography or cardiac computed tomography. Herein, we report a case of fatal embolic ST-elevation MI (STEMI) caused by mitral valve IE during the healed phase, which was clearly proven by the pathology findings.

摘要

感染性心内膜炎(IE)引起的栓塞性心肌梗死(MI)较为少见,但越来越被认为是一种重要的并发症。这种并发症通常发生在感染急性期的主动脉瓣心内膜炎患者中。它也具有很高的死亡率;然而,由于可用数据稀缺,其管理的最佳实践尚不清楚。此外,IE 引起的大多数栓塞性急性 MI(AMI)病例都是通过血管造影检查(如冠状动脉造影或心脏计算机断层扫描)间接诊断的。在此,我们报告了一例在愈合期由二尖瓣 IE 引起的致命性栓塞性 ST 段抬高型心肌梗死(STEMI),该病例通过病理学发现得到明确证实。

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