A Rare Case of Bacterial Endocarditis Leading to Aortic Valve Insufficiency and Presenting as Myocardial Infarction

Infective endocarditis (IE) is a life-threatening condition that can lead to valvular destruction, systemic embolization, and multiorgan failure. While IE typically presents with fever and murmur, acute myocardial infarction (MI) is a rare initial manifestation, particularly in postpartum women. We report the case of a 34-year-old postpartum female who presented with chest pain and hypotension. Electrocardiography showed ST-segment changes suggestive of anterolateral MI. Laboratory tests revealed elevated troponin, leukocytosis, and methicillin-resistant Staphylococcus aureus bacteremia. Coronary angiography identified thrombotic occlusions, and echocardiography showed a mobile vegetation on the aortic valve with severe regurgitation. She underwent angioplasty, targeted antibiotics, and emergency valve replacement. Intraoperative findings confirmed extensive valve destruction. Postoperative recovery was uneventful. This case underscores the importance of considering IE in young patients with MI-like symptoms and systemic infection. Early echocardiography, blood cultures, and timely surgical intervention are critical for survival in such complex presentations.