CC BY 4.0 · Aorta (Stamford) 2015; 03(01): 30-37
DOI: 10.12945/j.aorta.2015.14-051
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction

Case Report and Literature Review
Xiaoyue Mona Guo
1   Bonde Artificial Heart Laboratory, Yale University School of Medicine, New Haven, Connecticut, USA
,
Pramod Bonde
2   Section of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
› Author Affiliations
Further Information

Publication History

08 August 2014

23 October 2014

Publication Date:
24 September 2018 (online)

Abstract

Ruptured mycotic aneurysms occur infrequently in current clinical practice, and a pneumococcal etiology is even more rare. This case report describes a patient who initially presented with catheter lab activation for an acute ST-elevation myocardial infarction, receiving a full Plavix load. She was subsequently found to have a ruptured aortic aneurysm and underwent emergency surgical repair, with intraoperative findings of an aorta seeded with Streptococcus pneumonia. A retrospective evaluation of her history revealed clues of a previous upper respiratory infection and long-standing back pain. The subsequent literature review summarizes presentations and outcomes in previously reported, ruptured pneumococcal aneurysms and describes the relatively common occurrence of aortic conditions masquerading as acute myocardial infarctions. We provide recommendations to help approach similar situations in the future.

 
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    • References

    • 1 Gu YL, Svilaas T, van der Horst IC, Zijlstra F. Conditions mimicking acute ST-segment elevation myocardial infarction in patients referred for primary percutaneous coronary intervention. Neth Heart J 2008; 16: 325-331 . DOI: 10.1007/BF03086173
    • 2 McNamara RL, Wang Y, Herrin J, Curtis JP, Bradley EH, Magid DJ. , et al. Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol 2006; 47: 2180-2186 . DOI: 10.1016/j.jacc.2005.12.072