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J Thorac Cardiovasc Surg 2009;137:1278-1280
© 2009 The American Association for Thoracic Surgery

Brief Communication

Acute myocardial infarction and limb ischemia as manifestation of nonbacterial thrombotic endocarditis

Naoko Nagano, MDa, Jean-François Morin, MD, FRCSa,*, Dominique Joyal, MDb, Lawrence Rudski, MDb

a Division of Cardiac Surgery, Jewish General Hospital, Montreal, Quebec, Canada
b Division of Cardiology, Jewish General Hospital, Montreal, Quebec, Canada

Received for publication March 17, 2008; accepted for publication April 21, 2008.

* Address for reprints: Jean-François Morin, MD, FRCS, Division of Cardiac Surgery, Jewish General Hospital, A520, 3755 Chemin Côte-Ste-Catherine, Montreal, Quebec, Canada H3T 1E2. (Email: jmorin@surg.jgh.mcgill.ca).

The first 20% of the full text of this article appears below.

We report a 29-year-old patient who underwent right femoropopliteal bypass 2 years previously for right leg ischemia and was admitted recently to the hospital for acute myocardial infarction secondary to nonbacterial thrombotic endocarditis.

Clinical Summary

A 29-year-old man was admitted to an emergency department with acute onset chest pain. His electrocardiogram showed typical anterior acute myocardial infarction with remarkable ST segment elevations. Emergency coronary angiography was performed, which revealed a complete occlusion of the proximal left anterior descending artery. The right and circumflex arteries were entirely normal. After anticoagulation with heparin and abciximab, the occlusion was crossed and the clot was aspirated through an aspiration catheter. The vessel was successfully stented with a good result. The patient's medical history included a big toe amputation because of ischemia and femoropopliteal bypass surgery 2 years ago, at which time Burger disease was diagnosed. He did not have any other medical history except for cocaine use. An echocardiogram was performed the following day, which showed a 21 . . . [Full Text of this Article]






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