MYOCARDIAL-INFARCTION DUE TO CORONARY-ARTERY COMPRESSION BY AORTIC ROOT ABSCESS

A 44-year-old man with aortic valve disease presented with myocardial ischaemia and ultimately infarction in the presence of suspected endoc arditis. Thoracic computerised tomographic scan and coronary arteriogr aphy suggested the ischaemia was caused by external compression of the left coronary artery due to an aortic root abscess, later confirmed a t surgery. Myocardial ischaemia is an infrequent accompaniment of infe ctive endocarditis and is most commonly due to coexisting coronary dis ease. More rarely, emboli from vegetations may give rise to infarction . Although aortic root abscess is a well recognised complication of ao rtic valve endocarditis, coronary artery compression is an unusual mod e of presentation and we believe this to be the first reported case of myocardial infarction resulting from external compression in this set ting.