TY - JOUR
T1 - Bacterial endocarditis presenting as acute myocardial infarction
T2 - A cautionary note for the era of reperfusion
AU - Herzog, Charles A.
AU - Henry, Timothy D.
AU - Zimmer, Stevan D.
PY - 1991/1
Y1 - 1991/1
N2 - Coronary embolism is a known complication of bacterial endocarditis that sometimes causes acute myocardial infarction. The necessity for rapidly restoring coronary artery perfusion and the time constraints governing clinical decisions may prevent endocarditis from being diagnosed before pharmacologic or mechanical thrombolysis. This report describes the first documented cases of coronary angioplasty in two patients with acute myocardial infarction caused by bacterial endocarditis, and reviews the literature on coronary artery complications of bacterial endocarditis. The first patient developed a coronary artery mycotic aneurysm at the dilatation site; the second experienced a small intracerebral hemorrhage following reperfusion. It is, of course, unwise to generalize from two cases, but we believe that in patients who are most likely to have endocarditis as the cause of acute myocardial infarction, the impulse to follow conventional strategies for coronary reperfusion should be tempered by thoughts of possible consequences.
AB - Coronary embolism is a known complication of bacterial endocarditis that sometimes causes acute myocardial infarction. The necessity for rapidly restoring coronary artery perfusion and the time constraints governing clinical decisions may prevent endocarditis from being diagnosed before pharmacologic or mechanical thrombolysis. This report describes the first documented cases of coronary angioplasty in two patients with acute myocardial infarction caused by bacterial endocarditis, and reviews the literature on coronary artery complications of bacterial endocarditis. The first patient developed a coronary artery mycotic aneurysm at the dilatation site; the second experienced a small intracerebral hemorrhage following reperfusion. It is, of course, unwise to generalize from two cases, but we believe that in patients who are most likely to have endocarditis as the cause of acute myocardial infarction, the impulse to follow conventional strategies for coronary reperfusion should be tempered by thoughts of possible consequences.
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U2 - 10.1016/0002-9343(91)90583-J
DO - 10.1016/0002-9343(91)90583-J
M3 - Article
C2 - 2003522
AN - SCOPUS:0025774556
SN - 0002-9343
VL - 90
SP - 392
EP - 397
JO - The American Journal of Medicine
JF - The American Journal of Medicine
IS - 1
ER -