A rare case report of fatal acute myocardial infarction as a complication of myocardial abscess

Figures

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  Figure 1. Electrocardiogram on presentation with complete heart block, 2-mm ST segment elevation in II, III, and aVF leads.

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  Figure 2. Coronary angiography of left coronary artery with 60% stenosis of first diagonal branch, diffuse disease of circumflex artery, and 90% stenosis of the first obtuse marginal.

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  Figure 3. A—normal right coronary artery in 2017; B—diffuse disease of right coronary artery with acute occlusion of posterolateral artery; C—result of balloon angioplasty of posterolateral artery; D—anatomy of the right coronary artery.

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  Figure 4. Macroscopic view of the myocardial abscess. Diffuse myocardial abscess is localized near right coronary artery in the basal inferior segment of the left ventricle. Myocardial abscess was represented by a cavity that was 30 × 15 × 20 mm and filled with purulent masses of grey and yellow color, which have viscous consistency and volume of 4 mL.

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  Figure 5. Microscopic view. Haematoxylin-eosin (A, B—10×, C—20×, D—40×) stained microscopic images showing disorganization of cardiomyocytes (arrow-1), their destruction of various degrees of severity with their necrosis and the formation of a cavity filled with leukocytes (arrow-2). Interstitial edema, diffuse fibrotic changes, and lympho-leukocyte infiltration (arrow-3) were observed in undamaged areas. It is also important to note the hyperaemia of the microvasculatory, erythrocyte stasis, and edema of the stroma.