case_images: PMC6421800_01
case_images: Electrocardiogram on admission showed inferior wall ST elevation myocardial infarction. ST elevations in leads II, III, and aVF.
case_images: CRIC2019-1348607.001.jpg
case_images: PMC6421800_01_CRIC2019-1348607.001.jpg
case_images: fig1
case_images: ST elevations in leads II, III, and aVF consistent with inferior acute myocardial infarction (Figure 1). She was taken emergently to the cardiac catheterization lab where she was noted to have a completely occluded right coronary artery (RCA) (Figure 2).
case_images: Coronary angiography with 100% occlusion (arrow) at the midsegment of the right coronary artery from infective endocarditis embolus.
case_images: CRIC2019-1348607.002.jpg
case_images: PMC6421800_01_CRIC2019-1348607.002.jpg
case_images: fig2
case_images: ST elevations in leads II, III, and aVF consistent with inferior acute myocardial infarction (Figure 1). She was taken emergently to the cardiac catheterization lab where she was noted to have a completely occluded right coronary artery (RCA) (Figure 2).
case_images: Coronary angiography after synergy 3.0 x 38 mm drug-eluting stent (arrow) placed in RCA with return of TIMI 3 flow.
case_images: CRIC2019-1348607.003.jpg
case_images: PMC6421800_01_CRIC2019-1348607.003.jpg
case_images: fig3
case_images: An aspiration was attempted but was unsuccessful, so a 3.0 x 38 mm bioabsorbable drug-eluting stent was placed into the RCA along with balloon dilation of the proximal aspects of the posterior descending artery and distal RCA (Figure 3).
case_images: Coronary angiography showing widely patent left main, LAD, and circumflex, without evidence of chronic atherosclerosis.
case_images: CRIC2019-1348607.004.jpg
case_images: PMC6421800_01_CRIC2019-1348607.004.jpg
case_images: fig4
case_images: Left-sided coronaries were angiographically normal (Figure 4).
case_images: Transesophageal echocardiography revealing large aortic vegetation in longitudinal view (arrow).
case_images: CRIC2019-1348607.005.jpg
case_images: PMC6421800_01_CRIC2019-1348607.005.jpg
case_images: fig5
case_images: These findings were later confirmed with transesophageal echocardiogram, which also identified a patent foramen ovale with continuous right-to-left shunt (Figures 5 and 6).
case_images: Transesophageal echo showing patent foramen ovale (arrow).
case_images: CRIC2019-1348607.006.jpg
case_images: PMC6421800_01_CRIC2019-1348607.006.jpg
case_images: fig6
case_images: These findings were later confirmed with transesophageal echocardiogram, which also identified a patent foramen ovale with continuous right-to-left shunt (Figures 5 and 6).