Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction: Case Report and Literature Review

Aorta : Official Journal of the Aortic Institute at Yale-New Haven Hospital
Xiaoyue Mona Guo, Pramod Bonde

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.

Citations

May 2, 2015·Open Heart·John A ElefteriadesMatthew Hornick
Jul 22, 2020·The American Journal of Emergency Medicine·Oscar M P Jolobe

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