An Unusual Case of Aortic Vegetation Causing Coronary Artery
Microembolization and Sudden Death -- Case Report
Abstract
Infective endocarditis is not uncommon. Complications of endocarditis
may be related to hemodynamic instability through valve destruction and
ensuing congestive heart failure. Embolization of vegetations is a known
complication as well and may occur at any time, however there are
certain high-risk features that predispose to distal embolization. This
included vegetation size and causative organism especially with left
heart valve endocarditis. Central nervous system or peripheral embolism
to different parts of the body, may occur frequently and may be
subclinical or overt. Embolization down the coronary arteries may cause
myocardial ischemia, however, sudden cardiac death from infective
endocarditis embolizing down a coronary artery is an extremely rare
occurrence. The true incidence is not known, but in a recent study, 30
of 6000 (0.5%) cases of sudden cardiac death had a diagnosis of
infective endocarditis as cause of death, with most cases being
diagnosed post-mortem. Here, we present an unusual case of vegetation on
the aortic valve that embolized down the left main coronary artery
resulting in death.