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Year : 2016  |  Volume : 8  |  Issue : 6  |  Page : 259-262

Prosthetic aortic valve endocarditis with left main coronary artery embolism: A case report and review of the literature

1 Department of Medicine, St. Luke's Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
2 Department of Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA
3 Department of Neurology, Froedtert Memorial Lutheran Hospital, Medical College of Wisconsin, Milwaukee, WI, USA
4 Department of Medicine, Abington Jefferson Hospital, PA, USA
5 Department of Cardiology, Lehigh Valley Hospital, PA, USA
6 Department of Medicine, John Hopkins University School of Medicine, Baltimore, MD, USA

Correspondence Address:
Dr. Faisal Inayat
Department of Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York City, NY 10065
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1947-2714.185040

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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.

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