Abstract
A 42-year-old woman with a past medical history of i.v. drug abuse and endocarditis presented in our emergency department with severe and persisting chest pain. Cardiac markers were elevated (hsTrop T 1.210 µg/L; CK 800 U/L; CK-MB 100 U/L) and ECG revealed descending ST-segment depression in lead I and aVL with negative T waves and horizontal ST-segment depression in lead V4–V6. Inflammatory parameters were negative. Three months before, the patient was referred to our institution because of antibiotic-resistant fever, chills, elevated inflammatory parameters, and splenomegaly. Following microbiological analysis, Staphylococcus aureus was verified and transoesophageal echocardiography (TEE) demonstrated aorto-ventricular disconnection caused by a circumferential partly thrombosed aortic annulus abscess ( Panel A ). Surgery was performed, replacing …
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