A rare case report of fatal acute myocardial infarction as a complication of myocardial abscess

BACKGROUND: Myocardial abscess is a very rare life-threatening suppurative infection of the heart. Usually, myocardial abscess is a complication of infective endocarditis, and it is rarely associated with isolated myocardial infection. We present a case of an isolated myocardial abscess presenting with acute myocardial infarction. CASE SUMMARY: A 61-year-old man with a history of diabetes mellitus and coronary artery disease presented with a 3-h history of chest pain and inferior ST elevation. He had been treated for right-sided pneumonia 1.5 months prior to admission. Coronary angiography revealed acute occlusion of the posterolateral ventricular artery, and he underwent balloon angioplasty, which successfully restored TIMI-3 blood flow. Unfortunately, the patient went into cardiac arrest several hours later from which he could not be resuscitated. A post-mortem revealed a myocardial abscess in the inferior wall of the left ventricle. DISCUSSION: Myocardial abscess is a challenging diagnosis due to the speed of clinical deterioration and rarity. High clinical suspicion and urgent multimodality imaging may aid in the diagnosis.