VCOM Research Day Program Book 2023

Medical Student Research Case Reports

16 Left Sided Native Valve MRSA Endocarditis with Subsequent Embolization Presenting as Nstemi

Amina Banguedouar, OMS III; Shahzeib Syed, DO, PGY II; Gretchen Junko, DO Corresponding author:

Lewis Gale Medical Center, Salem Edward Via College of Osteopathic Medicine-Virginia Campus

A 34-year-old man with history of recent admission with methicillin resistant Staphylococcus aureus (MRSA) bacteremia, injection drug use with cocaine, and mobile mitral valve vegetation presents to the hospital with chest pain. A toxicology screening was negative for cocaine use, however the patient’s chest pain and high troponin levels persisted. This persistence reflects non-ST myocardial elevation (NSTEMI). This case of NSTEMI is likely originating from mitral valve vegetation demonstrated during previous admissions. On multiple occasions, blood cultures were positive for MRSA, which was complicated by multiple septic emboli to the spleen, kidneys, subpleural space, and encephalopathy with left parietal-occipital lobe embolism. The patient was eventually escalated to higher level care center given his comorbidities and clinical picture for further management. To our knowledge, NSTEMI secondary to mitral valve vegetations in the setting of MRSA has not previously been seen and we present the case here for the first time

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