Catheter Associated Thrombus Causing Septic Pulmonary Embolism Without Endocarditis or Phlebitis

Davidson, Joshua; Oleszak, Filip; Jagtiani, M.; Ajam, Mustafa

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6618

Cited by 2 publications

(1 citation statement)

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“…Septic emboli from indwelling catheters or patients on dialysis have been reported [ 11 ], yet few reports of STEMI from acute infective endocarditis secondary to IVDU are found in the literature.…”

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis Causing Acute Myocardial Infarction

Cohen¹,

Ford²,

Situ-LaCasse³

et al. 2020

Cureus

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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.

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Section: Discussionmentioning

confidence: 99%