Endocarditis is a well-known disease, yet septic embolization resulting in myocardial infarction is much rarer and very infrequently diagnosed in the emergency department (ED). Point-of-Care-Ultrasound (POCUS) can be used to confirm clinical suspicion within minutes of patient presentation, thereby expediting patient care.
We report the case of a 26-year-old female with known intravenous drug use who presented with altered mental status. Her clinical presentation prompted urgent evaluation in the ED with POCUS which showed a hyperdynamic functioning left ventricle, greater than 50% inferior vena cava collapse, and a large tricuspid valve vegetation. In light of the electrocardiogram (ECG) ST changes suggesting an acute myocardial infarction, the patient was emergently taken to the cardiac catheterization laboratory where coronary angiography revealed multiple coronary emboli. Primary diagnoses included endocarditis due to
Staphylococcus
, septic pulmonary embolism, and ST-elevated myocardial infarction (STEMI) due to embolic occlusion of the distal left anterior descending artery.
Myocardial infarction caused by septic embolization from endocarditis is a rare condition; however, POCUS is a quick, non-invasive tool that can aid the emergency medicine (EM) physician in identifying this life-threatening pathology thereby expediting appropriate care for the patient.
There were a high number of ticks that died in both groups but the data do not support our hypothesis that ivermectin can kill I scapularis. The study was not designed to determine whether it could prevent the transmission of tick-borne illness.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.