Cardiac catheterization carries a negligible risk of bacteremia. Post coronary artery intervention (PCI) bacteremia occurs frequently (in approximately 30% of cases); however, clinical sequelae occur rarely in such cases. Percutaneous coronary intervention has a greater bacteremic potential, probably due to the lengthy procedure time and the repeated insertion of interventional devices into the vascular system. When septic complications do occur after cardiovascular intervention the resulting morbidity and mortality are high and often much accelerated. We present the case of a patient who presumably developed a mycotic coronary artery aneurysm and infective pericarditis after undergoing PCI.
Key Points
* Coronary artery instrumentation can sometimes result in bacteremia that can lead to mycotic aneurysm.
* Myocardial ischemia is the most common clinical presentation for mycotic aneurysm, most likely from associated embolism.
* There are no clear guidelines governing treatment for these aneurysms.