{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:10:11Z","timestamp":1756278611840,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,10,21]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>A man in his 60s presented to the emergency department with central crushing chest pain on a background of a week\u2019s history of flu-like symptoms. An ECG demonstrated ischaemia with blood tests confirming myocardial injury; catheter angiography revealed an obstructed diagonal coronary artery. In addition, blood tests revealed elevated markers of inflammation, blood cultures grew <jats:italic>Streptococcus gordonii<\/jats:italic> and transthoracic echocardiography demonstrated a mitral valve lesion. A diagnosis of embolic infarction secondary to native mitral valve infective endocarditis was made. Imaging with [<jats:sup>18<\/jats:sup>F]Flurodeoxyglucose Positron Emission Tomography CT, cardiac MRI and brain MRI confirmed myocardial infarction, mitral valve infection and embolic phenomena within the brain, respectively. This case reinforces the need for strategic flexibility when faced with evolving clinical data, the role of multidisciplinary involvement in an endocarditis team and the benefits of multimodality imaging techniques to secure diagnostic certainty.<\/jats:p>","DOI":"10.1136\/bcr-2024-262842","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T02:20:21Z","timestamp":1731032421000},"page":"e262842","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Native mitral valve streptococcal endocarditis presenting as myocardial infarction and diagnosed with multimodality imaging"],"prefix":"10.1136","volume":"17","author":[{"given":"Joshua","family":"Wilcox","sequence":"first","affiliation":[{"name":"Guy's and St Thomas' Hospitals NHS Trust, London, UK"},{"name":"School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2744-8898","authenticated-orcid":false,"given":"Arshan Jimmy","family":"Dadrewalla","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas' Hospitals NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manil","family":"Subesinghe","sequence":"additional","affiliation":[{"name":"King's College London & Guy's and St. Thomas' PET Centre, London, UK"},{"name":"Department of Cancer Imaging, School of Biomedical Medical Engineering and Imaging Sciences, King's College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany","family":"Patterson","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas' Hospitals NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"2025082623450481000_17.11.e262842.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00067-7"},{"key":"2025082623450481000_17.11.e262842.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad625"},{"key":"2025082623450481000_17.11.e262842.3","doi-asserted-by":"crossref","first-page":"31","DOI":"10.7861\/clinmed.cme.20.1.1","article-title":"Infective endocarditis: A contemporary update","volume":"20","author":"Rajani","year":"2020","journal-title":"Clin Med (Lond)"},{"key":"2025082623450481000_17.11.e262842.4","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304354"},{"key":"2025082623450481000_17.11.e262842.5","doi-asserted-by":"crossref","first-page":"621","DOI":"10.21037\/acs.2019.09.03","article-title":"The value of an \u201cEndocarditis Team.\u201d","volume":"8","author":"Davierwala","year":"2019","journal-title":"Ann Cardiothorac Surg"},{"key":"2025082623450481000_17.11.e262842.6","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":"2025082623450481000_17.11.e262842.7","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1157\/13097922","article-title":"Acute Coronary Syndrome in Infective Endocarditis","volume":"60","author":"Manzano","year":"2007","journal-title":"Rev Esp Cardiol (Eng Ed)"},{"key":"2025082623450481000_17.11.e262842.8","first-page":"e28","article-title":"Infective endocarditis associated with acute myocardial infarction caused by septic emboli","volume":"1","author":"Okai","year":"2010","journal-title":"J Cardiol Cases"},{"key":"2025082623450481000_17.11.e262842.9","article-title":"Infective Endocarditis Causing Acute Myocardial Infarction","volume":"12","author":"Cohen","year":"2020","journal-title":"Cureus"},{"key":"2025082623450481000_17.11.e262842.10","doi-asserted-by":"crossref","unstructured":"Faluk MA , Vuu S , Kathi K , et al . Challenges in Managing Acute Myocardial Infarction Associated With Infective Endocarditis: A Case Report. J Investig Med High Impact Case Rep 2020;8. doi:10.1177\/2324709620960001","DOI":"10.1177\/2324709620960001"},{"key":"2025082623450481000_17.11.e262842.11","article-title":"ST-Segment Elevation Myocardial Infarction from Septic Emboli Secondary to Infective Endocarditis by Abiotrophia Defectiva","volume":"2020","author":"Khiatah","year":"2020","journal-title":"Case Rep Cardiol"},{"key":"2025082623450481000_17.11.e262842.12","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1016\/S0140-6736(20)30530-4","article-title":"An alarming rise in incidence of infective endocarditis in England since 2009: why?","volume":"395","author":"Thornhill","year":"2020","journal-title":"Lancet"},{"key":"2025082623450481000_17.11.e262842.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62007-9"},{"key":"2025082623450481000_17.11.e262842.14","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1161\/CIRCULATIONAHA.120.046723","article-title":"Prevalence of Infective Endocarditis in Streptococcal Bloodstream Infections Is Dependent on Streptococcal Species","volume":"142","author":"Chamat-Hedemand","year":"2020","journal-title":"Circulation"},{"key":"2025082623450481000_17.11.e262842.15","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.015134"},{"key":"2025082623450481000_17.11.e262842.16","doi-asserted-by":"crossref","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":"2025082623450481000_17.11.e262842.17","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262842","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:45:17Z","timestamp":1756277117000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":17,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,7]]},"published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1136\/bcr-2024-262842"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262842","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,11]]}}}