Acute ST-Elevation Myocardial Infarction Complicating Infective Endocarditis: A Case Report and Review of Reported Outcomes After Revascularization

Acute myocardial infarction in the context of infective endocarditis is a dreadful complication. Various mechanisms have been proposed to explain this complication; embolization of fragments of valvular vegetations into the coronary tree is one possible mechanism. Early mortality with this complication is reportedly high. Moreover, outcomes after treatment, either with percutaneous or surgical intervention, are not well-described in the literature. We report a case of acute ST-elevation myocardial infarction complicating bacterial native aortic valve endocarditis. Despite aspiration of infective debris and stent implantation in the left anterior descending coronary artery, the patient died from cardiogenic and septic shock. We also summarize the literature reporting outcomes of such patients undergoing percutaneous coronary intervention and comparing them to the outcomes of patients undergoing surgical revascularization.