{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:01:05Z","timestamp":1780621265995,"version":"3.54.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute ST-elevation myocardial infarction (STEMI) secondary to septic coronary embolization is an exceptionally uncommon complication of Infective endocarditis (IE). It\u2019s diagnostic and therapeutic complexity poses a unique challenge in clinical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 79-year-old woman with a history of asthma, dyslipidemia, and breast cancer status post right mastectomy presented to the emergency department with acute STEMI secondary to septic coronary embolization caused by IE of both mitral and aortic valves in addition to the presence of perivalvular abscess. Coronary angiography revealed distal occlusion of the left anterior descending (LAD) artery, and because of the embolic and infectious nature of occlusion, balloon angioplasty without stent placement was performed. Our patient needed urgent surgical intervention; however, surgery was not feasible, leaving prolonged antibiotic treatment as the only possible option. Although treatment with antibiotics alone initially achieved clinical stabilization, the abscess persisted on follow-up imaging, and 2 months later, the patient developed cardiogenic shock and passed away.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case emphasizes the importance of having a high index of suspicion in the diagnosis of STEMI secondary to IE. It also highlights diagnostic and therapeutic challenges, in which early recognition relies on careful clinical assessment and appropriate imaging. Our case draws attention both to the limitations of antibiotic therapy when used alone and stresses the importance of continuous monitoring in patients who are not surgical candidates, although early escalation of treatment, including surgical intervention when indicated, is essential to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag382","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:35:59Z","timestamp":1779190559000},"source":"Crossref","is-referenced-by-count":0,"title":["Coronary septic embolism presenting as acute myocardial infarction: A rare manifestation of infective endocarditis: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4961-5588","authenticated-orcid":false,"given":"Ahmad H","family":"Alhajj Mohammad","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University , P.O. Box 6573\/14, Beirut ,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Saleh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University , P.O. Box 6573\/14, Beirut ,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexie","family":"Freiji","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University , P.O. Box 6573\/14, Beirut ,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Badran","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University , P.O. Box 6573\/14, Beirut ,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naji","family":"Abi Rached","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lebanese Hospital Geitaoui-UMC, Faculty of Medical Science-Lebanese University , P.O. Box 6573\/14, Beirut ,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"2026060420092116200_ytag382-B1","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/B978-0-443-11611-7.00034-7","volume-title":"Oh's Intensive Care Manual","author":"Galluccio","year":"2026"},{"key":"2026060420092116200_ytag382-B2","doi-asserted-by":"crossref","first-page":"240","DOI":"10.2174\/1871529X10909040240","article-title":"Complications of infective endocarditis","volume":"9","author":"Mocchegiani","year":"2009","journal-title":"Cardiovasc Hematol Disord Drug Targets"},{"key":"2026060420092116200_ytag382-B3","first-page":"yty032","article-title":"Myocardial infarction associated with infective endocarditis: a case series","volume":"2","author":"Calero-N\u00fa\u00f1ez","year":"2018","journal-title":"Eur Heart J Case Rep"},{"key":"2026060420092116200_ytag382-B4","doi-asserted-by":"crossref","first-page":"e005587","DOI":"10.1161\/CIRCINTERVENTIONS.117.005587","article-title":"Coronary embolism among ST-segment-elevation myocardial infarction patients: mechanisms and management","volume":"11","author":"Popovic","year":"2018","journal-title":"Circ Cardiovasc Interv"},{"key":"2026060420092116200_ytag382-B5","doi-asserted-by":"crossref","first-page":"2866","DOI":"10.1093\/eurheartj\/ehaf289","article-title":"Acute coronary syndromes: mechanisms, challenges, and new opportunities","volume":"46","author":"Kraler","year":"2025","journal-title":"Eur Heart J"},{"key":"2026060420092116200_ytag382-B6","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.tcm.2022.07.004","article-title":"Coronary artery embolism and acute coronary syndrome: a critical appraisal of existing data","volume":"34","author":"Monin","year":"2024","journal-title":"Trends Cardiovasc Med"},{"key":"2026060420092116200_ytag382-B7","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1001\/jama.2022.0358","article-title":"Diagnosis and treatment of acute coronary syndromes: a review","volume":"327","author":"Bhatt","year":"2022","journal-title":"JAMA"},{"key":"2026060420092116200_ytag382-B8","doi-asserted-by":"crossref","first-page":"ytab302","DOI":"10.1093\/ehjcr\/ytab302","article-title":"ST-segment elevation myocardial infarction due to septic coronary embolism: a case report","volume":"5","author":"Mazzoni","year":"2021","journal-title":"Eur Heart J Case Rep"},{"key":"2026060420092116200_ytag382-B9","doi-asserted-by":"crossref","first-page":"105082","DOI":"10.1016\/j.jaccas.2025.105082","article-title":"Native valve infective endocarditis presenting with a non-ST-segment elevation myocardial infarction","volume":"30","author":"Khiroya","year":"2025","journal-title":"JACC Case Rep"},{"key":"2026060420092116200_ytag382-B10","doi-asserted-by":"crossref","first-page":"ytaf037","DOI":"10.1093\/ehjcr\/ytaf037","article-title":"Coronary septic embolism presenting as acute myocardial infarction. A case report of a singular manifestation of infective endocarditis","volume":"9","author":"Ferreira Carvalho","year":"2025","journal-title":"Eur Heart J Case Rep"},{"key":"2026060420092116200_ytag382-B11","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1016\/j.amjcard.2019.01.033","article-title":"ST-elevation myocardial infarction associated with infective endocarditis","volume":"123","author":"Nazir","year":"2019","journal-title":"Am J Cardiol"},{"key":"2026060420092116200_ytag382-B12","first-page":"22","article-title":"Septic embolization of left and right coronary arteries resulting in sudden death: a rare complication of infective endocarditis","volume":"10","author":"Hewarathna","year":"2014","journal-title":"J Cardiol Cases"},{"key":"2026060420092116200_ytag382-B13","doi-asserted-by":"crossref","first-page":"3948","DOI":"10.1093\/eurheartj\/ehad193","article-title":"2023 ESC guidelines for the management of endocarditis: developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM)","volume":"44","author":"Delgado","year":"2023","journal-title":"Eur Heart J"},{"key":"2026060420092116200_ytag382-B14","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ejim.2020.04.017","article-title":"Embolic risk stratification and prognostic impact of early surgery in left-sided in- fective endocarditis","volume":"78","author":"Scheggi","year":"2020","journal-title":"Eur J Intern Med"},{"key":"2026060420092116200_ytag382-B15","first-page":"E166","article-title":"Acute ST-elevation myocardial infarction due to septic embolism: a case report and review of management options","volume":"85","author":"Singh","year":"2015","journal-title":"Cathet Cardiovasc Intervent"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag382\/68349148\/ytag382.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/6\/ytag382\/68349148\/ytag382.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/6\/ytag382\/68349148\/ytag382.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:09:29Z","timestamp":1780618169000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag382\/8688557"}},"subtitle":[],"editor":[{"given":"Christoph","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"John","family":"Kanakakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag382","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,5,20]]},"article-number":"ytag382"}}