Case Report

Infective Mycotic Aneurysm Presenting as Transient Acute Coronary Occlusion and Infectious Pericarditis

Authors: Aaref Badshah MD, Fahad Younas MD, Muhammad Janjua MD

Abstract

Abstract:Cardiac catheterization carries a negligible risk of bacteremia. Post coronary artery intervention (PCI) bacteremia occurs frequently (in approximately 30% of cases); however, clinical sequelae occur rarely in such cases. Percutaneous coronary intervention has a greater bacteremic potential, probably due to the lengthy procedure time and the repeated insertion of interventional devices into the vascular system. When septic complications do occur after cardiovascular intervention the resulting morbidity and mortality are high and often much accelerated. We present the case of a patient who presumably developed a mycotic coronary artery aneurysm and infective pericarditis after undergoing PCI.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

References1. Golubev N, Schwannenthal E, Di Segni E, et al. Echocardiographic imaging of coronary artery abscess following stent implantation. Echocardiography 2004;21:87–88.GolubevN]]SchwannenthalE]]Di SegniE&etal;Echocardiographic imaging of coronary artery abscess following stent implantation.Echocardiography20042187-882. Leroy O, Martin E, Prat A, et al. Fatal infection of coronary stent implantation. Cathet Cardiovasc Diagn 1996;39:168–170; discussion 171.3. Sohail MR, Khan AH, Holmes DR Jr, et al. Infectious complications of percutaneous vascular closure devices. Mayo Clin Proc 2005;80:1011–1015.SohailMR]]KhanAH]]HolmesDRJr&etal;Infectious complications of percutaneous vascular closure devices.Mayo Clin Proc2005801011-10154. McCready RA, Siderys H, Pittman JN, et al. Septic complications after cardiac catheterization and percutaneous transluminal coronary angioplasty. J Vasc Surg 1991;14:170–174.McCreadyRA]]SiderysH]]PittmanJN&etal;Septic complications after cardiac catheterization and percutaneous transluminal coronary angioplasty.J Vasc Surg199114170-1745. Timsit JF, Wolff MA, Bédos JP, et al. Cardiac abscess following percutaneous transluminal coronary angioplasty. Chest 1993;103:639–641.TimsitJF]]WolffMA]]BédosJP&etal;Cardiac abscess following percutaneous transluminal coronary angioplasty.Chest1993103639-6416. Dieter RS. Coronary artery stent infection. Clin Cardiol 2000;23:808–810.DieterRSCoronary artery stent infection.Clin Cardiol200023808-8107. Liu JC, Cziperle DJ, Kleinman B, et al. Coronary abscess: a complication of stenting. Catheter Cardiovasc Interv 2003;58:69–71.LiuJC]]CziperleDJ]]KleinmanB&etal;Coronary abscess: a complication of stenting.Catheter Cardiovasc Interv20035869-718. Salinas G, Kumar D, Lick S, et al. Infective coronary aneurysms: a complication of percutaneous coronary intervention. Tex Heart Inst J 2007;34:91–94.SalinasG]]KumarD]]LickS&etal;Infective coronary aneurysms: a complication of percutaneous coronary intervention.Tex Heart Inst J20073491-949. Osevala MA, Heleotis TL, DeJene BA. Successful treatment of a ruptured mycotic coronary artery aneurysm. Ann Thorac Surg 1999;67:1780–1782.OsevalaMA]]HeleotisTL]]DeJeneBASuccessful treatment of a ruptured mycotic coronary artery aneurysm.Ann Thorac Surg1999671780-178210. Lemoine J, Popovic B, Amrein D. [Mycotic coronary aneurysm with Escherichia coli sepsis: a case report]. Ann Cardiol Angeiol (Paris) 2007;56:145–147 [in French].11. Reece IJ, al Tareif H, Tolia J, et al. Mycotic aneurysm of the left anterior descending coronary artery after aortic endocarditis. A case report and brief review of the literature. Tex Heart Inst J 1994;21:231–235.ReeceIJ]]al TareifH]]ToliaJ&etal;Mycotic aneurysm of the left anterior descending coronary artery after aortic endocarditis. A case report and brief review of the literature.Tex Heart Inst J199421231-23512. Takahashi Y, Sasaki Y, Shibata T, et al. Successful surgical treatment of a mycotic right coronary artery aneurysm complicated by a fistula to the right atrium. Jpn J Thorac Cardiovasc Surg 2005;53:661–664.TakahashiY]]SasakiY]]ShibataT&etal;Successful surgical treatment of a mycotic right coronary artery aneurysm complicated by a fistula to the right atrium.Jpn J Thorac Cardiovasc Surg200553661-664