Autopsy and Case Reports
https://app.periodikos.com.br/journal/autopsy/article/doi/10.4322/acr.2023.444
Autopsy and Case Reports
Autopsy Case Report

Myocardial infarction due to septic thromboembolism in chronic rheumatic heart disease

Suneel Rachagiri; Aravind Sekar; Saurabh Mehrotra; Uma Nahar Saikia

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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.

Keywords

Aortic Valve, Embolism, Endocarditis

References

1 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.

2 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.

3 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.

4 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.

5 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.

6 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.

7 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.

8 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.

9 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.

10 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.
 


Submitted date:
04/16/2023

Accepted date:
07/14/2023

Publication date:
08/28/2023

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