# A Rare Case of Bacterial Endocarditis Leading to Aortic Valve Insufficiency and Presenting as Myocardial Infarction

## TL;DR

A rare case shows how bacterial endocarditis can mimic a heart attack, leading to severe valve damage and requiring urgent surgery.

## Contribution

Highlights a rare presentation of infective endocarditis as acute myocardial infarction in a postpartum woman.

## Key findings

- The patient presented with MI-like symptoms but had methicillin-resistant Staphylococcus aureus bacteremia and aortic valve vegetation.
- Emergency valve replacement and targeted antibiotics were critical for recovery.
- Early echocardiography and blood cultures are essential for diagnosing complex IE cases.

## Abstract

Infective endocarditis (IE) is a life-threatening condition that can lead to valvular destruction, systemic embolization, and multiorgan failure. While IE typically presents with fever and murmur, acute myocardial infarction (MI) is a rare initial manifestation, particularly in postpartum women. We report the case of a 34-year-old postpartum female who presented with chest pain and hypotension. Electrocardiography showed ST-segment changes suggestive of anterolateral MI. Laboratory tests revealed elevated troponin, leukocytosis, and methicillin-resistant Staphylococcus aureus bacteremia. Coronary angiography identified thrombotic occlusions, and echocardiography showed a mobile vegetation on the aortic valve with severe regurgitation. She underwent angioplasty, targeted antibiotics, and emergency valve replacement. Intraoperative findings confirmed extensive valve destruction. Postoperative recovery was uneventful. This case underscores the importance of considering IE in young patients with MI-like symptoms and systemic infection. Early echocardiography, blood cultures, and timely surgical intervention are critical for survival in such complex presentations.