Metastatic myocardial abscess on the posterior wall of the left ventricle: a case report

Javaid Iqbal¹ , Iftikhar Ahmed² and Wazir Baig³

¹Department of Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, UK

²Department of Medicine, Scarborough General Hospital, North Yorkshire, UK

³Department of Cardiology, Leeds General Infirmary, West Yorkshire, UK

author email corresponding author email

Journal of Medical Case Reports 2008, 2:258doi:10.1186/1752-1947-2-258


Published:	5 August 2008

Abstract

Introduction

Myocardial abscess is a rare and potentially fatal condition. Metastatic myocardial abscess in the setting of infective endocarditis has been infrequently reported in the medical literature. To the best of the authors' knowledge no case of myocardial abscess affecting the free wall of the left ventricle secondary to infective endocarditis of a right-sided heart valve has been reported previously.

Case presentation

We report a case of tricuspid valve endocarditis caused by Staphylococcus aureus and resulting in a myocardial abscess on the posterior wall of the left ventricle, far from the active valvular infection. We also briefly discuss the role of different investigation modalities including cardiac magnetic resonance imaging in diagnosing myocardial abscess.

Conclusion

Myocardial abscess is a life-threatening illness. A high index of clinical suspicion is required to make a prompt diagnosis. Final diagnosis may need multi-modality imaging. An early diagnosis, aggressive medical therapy, multidisciplinary care and timely surgical intervention may save life in this otherwise fatal condition.