Carvalho, Mariana FerreiraGonçalves, CarolinaSantos, Beatriz SaldanhaMorais, JoãoSøholm, HelleGalyavich, AlbertRroku, AndiLuo, Elton2025-09-162025-09-162025-01-29Mariana Ferreira Carvalho, Carolina Gonçalves, Beatriz Saldanha Santos, João Morais, Coronary septic embolism presenting as acute myocardial infarction. A case report of a singular manifestation of infective endocarditis, European Heart Journal - Case Reports, Volume 9, Issue 2, February 2025, ytaf037, https://doi.org/10.1093/ehjcr/ytaf037http://hdl.handle.net/10400.8/14076Supplementary material is available at European Heart Journal - Case Reports onlineWe thank the medical staff involved in the patient's care for their support and contribution.Article number - ytaf037Background Acute ST-elevation myocardial infarction (STEMI) complicated by infective endocarditis (IE) presents a unique challenge in clinical management, especially when associated with septic embolism leading to coronary artery occlusion. Case summary The current clinical report describes the case of a 72-year-old male with a history of arterial hypertension, dyslipidaemia, and severe obstructive sleep apnea. The patient presented with anterior STEMI due to an embolic occlusion in the left anterior descending (LAD) artery, secondary to IE. Coronary angiography revealed embolic occlusion at the LAD origin, and balloon angioplasty without stent placement was performed, considering the embolic and infectious nature of the occlusion. Despite targeted interventions, including broad-spectrum antibiotics and support for cardiogenic shock, the patient's condition deteriorated, leading to cardiac arrest and subsequent death on the fourth day of hospitalization. Conclusion This case emphasizes the critical need for adapting STEMI management in the presence of IE. It highlights the importance of considering IE in STEMI differential diagnosis and adjusting intervention strategies accordingly.engCase reportInfective endocarditisMyocardial infarctionSeptic embolismAcute coronary syndromejournal article10.1093/ehjcr/ytaf0372514-2119