PMID- 30508888
OWN - NLM
STAT- MEDLINE
DCOM- 20190107
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 48
DP  - 2018 Nov
TI  - Infective endocarditis complicated with nonobstructive ST elevation myocardial 
      infarction related to septic embolism with intracranial hemorrhage: A case 
      report.
PG  - e13089
LID - 10.1097/MD.0000000000013089 [doi]
LID - e13089
AB  - RATIONALE: Infective endocarditis (IE) complicated with obstructive ST elevation 
      myocardial infarction (STEMI) has been reported in the literature and which were 
      mostly related to coronary artery embolism, obstruction, or compression. However, 
      there has been no reported case discussing about IE complicated with 
      nonobstructive STEMI. PATIENT CONCERNS: In this report, we report a 38-year-old 
      female suffering from intermittent fever and was later diagnosed as IE. Initially 
      antibiotic was given and mitral valve surgery was also arranged due to large 
      vegetation with severe mitral regurgitation. Nevertheless, sudden conscious loss 
      with desaturation happened and brain computed tomography (CT) showed intracranial 
      and subdural hemorrhage related to possible septic embolism. In addition, 
      electrocardiography (ECG) revealed ST elevation over precordial leads, and 
      elevation of cardiac enzymes was also noted. DIAGNOSES: Emergent coronary 
      angiography was arranged but result showed normal coronary arteries without any 
      evidence of stenosis. The diagnoses of IE complicated with nonobstructive STEMI 
      were made. INTERVENTIONS: After coronary angiography, the patient underwent 
      craniotomy and subdural hematoma removal. Surprisingly, follow-up ECG also 
      revealed ST segment resolution. OUTCOMES: The patient received full course 
      antibiotic treatment and follow-up brain CT also showed improvement of 
      intracranial hemorrhage (ICH) and subdural hemorrhage. Because follow-up 
      echocardiography still revealed severe mitral regurgitation with mitral valve 
      prolapse due to leaflet destruction with partially decreased vegetation size, 
      mitral valve replacement with bioprosthetic valve was performed and the patient 
      was finally discharged smoothly. LESSONS: In our knowledge, this case should be 
      the 1st case of IE complicated with nonobstructive STEMI, which reminds 
      physicians that nonobstructive STEMI is still an extremely rare but possible 
      complication of IE and septic embolism related ICH should be carefully surveyed 
      in this rare patient group.
FAU - Liu, Yi-Hsueh
AU  - Liu YH
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
FAU - Lee, Wen-Hsien
AU  - Lee WH
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
AD  - Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, 
      Kaohsiung, Taiwan.
FAU - Chu, Chun-Yuan
AU  - Chu CY
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
AD  - Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, 
      Kaohsiung, Taiwan.
FAU - Su, Ho-Ming
AU  - Su HM
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
FAU - Lin, Tsung-Hsien
AU  - Lin TH
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
FAU - Yen, Hsueh-Yei
AU  - Yen HY
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
FAU - Voon, Wen-Chol
AU  - Voon WC
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
FAU - Lai, Wen-Ter
AU  - Lai WT
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
FAU - Sheu, Sheng-Hsiung
AU  - Sheu SH
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
FAU - Hsu, Po-Chao
AU  - Hsu PC
AD  - Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical 
      University Hospital.
AD  - Department of Internal Medicine.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Adult
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Coronary Angiography
MH  - Craniotomy
MH  - Embolism/*complications
MH  - Endocarditis, Bacterial/*complications/drug therapy
MH  - Female
MH  - Hematoma, Subdural, Acute
MH  - Humans
MH  - Intracranial Hemorrhages/*complications/surgery
MH  - Mitral Valve Insufficiency/complications
MH  - ST Elevation Myocardial Infarction/*complications
PMC - PMC6283201
EDAT- 2018/12/05 06:00
MHDA- 2019/01/08 06:00
PMCR- 2018/11/30
CRDT- 2018/12/05 06:00
PHST- 2018/12/05 06:00 [entrez]
PHST- 2018/12/05 06:00 [pubmed]
PHST- 2019/01/08 06:00 [medline]
PHST- 2018/11/30 00:00 [pmc-release]
AID - 00005792-201811300-00008 [pii]
AID - MD-D-18-04498 [pii]
AID - 10.1097/MD.0000000000013089 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Nov;97(48):e13089. doi: 10.1097/MD.0000000000013089.