Infective endocarditis in the elderly: severe mitral regurgitation in acute coronary syndrome. A case report highlighting the changing patterns of endocarditis

Endocarditis is increasingly becoming a disease of the elderly. We report a case of a 70 year old man with coronary artery disease, who presented with chest pain and fever. His cardiac markers were elevated and an echocardiogram revealed large vegetation on the anterior leaflet of the mitral valve. He also had severe mitral regurgitation and hypokinesia of the posterior and inferior wall. The association of a mitral regurgitant valve secondary to myocardial infarction and bacterial endocarditis has not been reported in the literature making this case unique and interesting. A discussion on the changing patterns of infective endocarditis reveals interesting facts which are useful in the management of such cases