Myocardial infarction due to septic thromboembolism in chronic rheumatic heart disease

Authors

DOI:

https://doi.org/10.4322/acr.2023.444

Keywords:

Aortic Valve, Embolism, Endocarditis

Abstract

Chronic rheumatic heart disease (RHD) is the most troublesome complication of rheumatic fever. Extensive valvular scarring and ventricular remodeling due to pressure and volume overload occur in chronic RHD. Deformed valves are at potential risk for developing infective endocarditis (IE) with further systemic embolism. We hereby describe a case of a patient diagnosed with chronic rheumatic heart disease and severe ventricular dysfunction, planned for aortic valve replacement. The patient developed septic shock during a hospital stay. The autopsy revealed infective endocarditis in the aortic valve with septic thromboembolism in the peripheral branches of the coronary artery and early multifocal myocardial infarction changes.

Downloads

References

Remenyi B, ElGuindy A, Smith SC Jr, Yacoub M, Holmes DR Jr. Valvular aspects of rheumatic heart disease. Lancet. 2016;387(10025):1335-46. http://dx.doi.org/10.1016/S0140-6736(16)00547-X. PMid:27025439.

Passos LSA, Nunes MCP, Aikawa E. Rheumatic heart valve disease pathophysiology and underlying mechanisms. Front Cardiovasc Med. 2021;7:612716. http://dx.doi.org/10.3389/fcvm.2020.612716. PMid:33537348.

Okai I, Inoue K, Yamaguchi N, et al. Infective endocarditis associated with acute myocardial infarction caused by septic emboli. J Cardiol Cases. 2009;1(1):e28-32. http://dx.doi.org/10.1016/j.jccase.2009.06.003. PMid:30615754.

Roux V, Salaun E, Tribouilloy C, et al. Coronary events complicating infective endocarditis. Heart. 2017;103(23):1906-10. http://dx.doi.org/10.1136/heartjnl-2017-311624. PMid:28642290.

Calero-Núñez S, Ferrer Bleda V, Corbí-Pascual M, et al. Myocardial infarction associated with infective endocarditis: a case series. Eur Heart J Case Rep. 2018;2(1):yty032. http://dx.doi.org/10.1093/ehjcr/yty032. PMid:31020108.

Mutagaywa RK, Vroon JC, Fundikira L, et al. Infective endocarditis in developing countries: an update. Front Cardiovasc Med. 2022;9:1007118. http://dx.doi.org/10.3389/fcvm.2022.1007118. PMid:36172579.

Ajmone Marsan N, Delgado V, Shah DJ, et al. Valvular heart disease: shifting the focus to the myocardium. Eur Heart J. 2023;44(1):28-40. http://dx.doi.org/10.1093/eurheartj/ehac504. PMid:36167923.

Manzano MC, Vilacosta I, San Román JA, et al. Acute coronary syndrome in infective endocarditis. Rev Esp Cardiol. 2007;60(1):24-31. http://dx.doi.org/10.1157/13097922. PMid:17288952.

Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36(44):3075-128. http://dx.doi.org/10.1093/eurheartj/ehv319. PMid:26320109.

Hu W, Wang X, Su G. Infective endocarditis complicated by embolic events: pathogenesis and predictors. Clin Cardiol. 2021;44(3):307-15. http://dx.doi.org/10.1002/clc.23554. PMid:33527443.

Downloads

Published

2023-08-28

Issue

Vol. 13 (2023)

Section

Autopsy Case Report

License

Copyright (c) 2023 Autopsy and Case Reports

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors of articles published by Autopsy and Case Report retain the copyright of their work without restrictions, licensing it under the Creative Commons Attribution License - CC-BY, which allows articles to be re-used and re-distributed without restriction, as long as the original work is correctly cited.

How to Cite

Suneel Rachagiri, Aravind Sekar, Saurabh Mehrotra, & Uma Nahar Saikia. (2023). Myocardial infarction due to septic thromboembolism in chronic rheumatic heart disease. Autopsy and Case Reports, 13, e2023444. https://doi.org/10.4322/acr.2023.444