F. Breuckmann C. K. Naber D. Boese A. Lind H. Wieneke J. Barkhausen R. Erbel Mitral valve endocarditis leading to acute myocardial and cerebellar infarction in a young adult Clin Res Cardiol 95:657–662 (2006) DOI 10.1007/s00392-006-0436-1 CLINICAL CORREPONDENCE Received: 18 April 2006 Accepted: 24 July 2006 Published online: 8 September 2006 Dr. med. Frank Breuckmann, MD ( ) ) Christoph K. Naber, MD · Dirk Boese, MD Alexander Lind, MD · Heinrich Wieneke, MD Raimund Erbel, MD Department of Cardiology West German Heart Center Essen University of Essen Hufelandstr. 55 45122 Essen, Germany Tel.: +49-201/723-4888 Fax: +49-201/723-5401 E-Mail: Frank.Breuckmann@uk-essen.de Joerg Barkhausen, MD Department of Diagnostic and Interventional Radiology and Neuroradiology University Hospital Essen Essen, Germany Sirs: Despite advantages in diagnosis and therapy, endocarditis still represents a severe cardiovascular disease with often poor prognosis and potentially live-threatening complications [1–3]. The overall em- bolism rate in infective endocarditis ranges from about 20 to 50% [4, 5]. Cerebral complications such as strokes are relatively frequent at least prior to antibiotic therapy [6, 7]. Although coronary embo- lism of fragments of valvular vegetations is not an uncommon finding in autopsy studies of infective endocarditis, clinically apparent myocardial infarc- tion is rarely described [8, 9]. Case Presentation We here report a 21-year-old male patient who ini- tially presented in a nearby general hospital with sudden neurological deficit in terms of headache, dysmetria, intention tremor, dysdiadochokinesia, dysarthria, unilateral trigeminal sensory dysfunction, and Horner syndrome. Primary diagnosis by cere- bral computed tomography disclosed infarction of the posterior inferior cerebellar artery (Fig. 1). Addi- tionally, the patient complained about increasing left-thoracic pain radiating to his left upper arm and jaw corresponding to an acute coronary syndrome as well as subfebrile temperatures. At the same time, the ECG showed ST-segment elevations in leads V2– Fig. 1 Cranial CT of a 21-year-old male patient complaining about neurolog- ical symptoms demonstrating infarction of the posterior inferior cerebellar artery (arrow)