CORONARY EMBOLISM WITH MYOCARDIAL INFARCTION—COMPLICATION OF VERRUCOUS ENDOCARDITIS

Coronary embolism, as a cause for myocardial infarction, has probably been diagnosed clinically only three or four times.¹ Small coronary emboli are usually of little clinical significance and are not infrequently seen at autopsy in cases of bacterial endocarditis² and in some forms of verrucous endocarditis (verrucal endocardiosis).³ Emboli large enough to produce gross myocardial damage have been reported convincingly in only about 50 cases.¹ The literature on this subject has been reviewed several times in recent years.⁴ The emboli reported have almost always been blood clots which have arisen either from lesions within the coronary arteries, aorta, or endocardium or from the lower extremities by way of a patent foramen ovale. There are only two reports of nonthrombotic emboli. These included a calcified nodule arising from the aortic valve^4b and a caseous plug arising from the lungs in a case of pulmonary tuberculosis.