Treatment Dilemma? A Hybrid Approach for a Rare Phenomenon of Coronary Artery Septic Embolisation in Infective Endocarditis: A Case Report

Diagnosing acute coronary syndrome (ACS) in the context of infective endocarditis can be difficult due to overlapping symptoms and the possibility of atypical presentations.A 16-year-old male was admitted for fulminant infective endocarditis with a large perivalvular mitral valve vegetation.Despite completion of the antibiotics treatment, he experienced NSTEMI while awaiting a planned mechanical mitral valve replacement.After HEART team discussion, the patient subsequently underwent percutaneous coronary intervention of the LAD followed by an uneventful mechanical mitral valve replacement. Key Clinical MessageManipulation of the coronary vessels during traditional catheterization can potentially cause more harm when treating acute coronary syndrome caused by septic emboli in the setting of infective endocarditis.This unique population should be managed by a multidisciplinary team comprised of specialists in interventional and non-interventional cardiology, cardiothoracic surgery, and infectious diseases.