- Infective endocarditis is a bacterial or fungal infection of the valvular or endocardial surface of the heart that usually occurs in patients with underlying organic heart disease. The clinical presentation depends not only on the infecting organism but also the affected structure. A myriad of structural and hemodynamic complications may occur; for example, among a series of 223 patients with infective endocarditis (1), 57% had one complication while 6% had six or more complications. The complications of infective endocarditis are categorized as cardiac, septic, embolic, neurological, musculoskeletal, renal, and those derived from medical treatment. The nature and frequency of these complications depend on numerous variables, such as the infecting pathogen, the location, the illness duration, and the type of treatment. The case is described of a rare catastrophic complication of infective endocarditis, namely the embolization of vegetative material into the left main coronary artery, which caused vessel occlusion and sudden death.