Image - Interventional Cardiology (2017) Volume 9, Issue 2
Coronary air embolism during coronary angiography: reminder of a potentially lethal but avoidable complication
- Corresponding Author:
- Kunal Mahajan
Department of Cardiology
Indira Gandhi Medical College and Hospital
Shimla, HP, India
Tel: 00918628864820
E-mail: kunalmahajan442@gmail.com
Submitted: 15 March 2017 Accepted: 16 March 2017 Published online: 21 March 2017
Abstract
Clinical Presentation
A 45 years old male with exceptional angina and a positive treadmill test was subjected to coronary angiogram. Left coronary artery was normal. During right coronary artery (RCA) injection, patient developed severe chest pain and hypotension along with 5-6 mm ST segment elevation in inferior leads on Electrocardiogram. Multiple small air bubbles were seen in RCA (arrowheads in Figure 1A) causing decreased perfusion of the distal RCA bed. Patient was immediately ventilated with 100% oxygen and intravenous fluids were rushed. Forceful injection of saline was administered in RCA. Complete resolution of ST segment occurred within 2 minutes time and patient became chest pain free and normotensive. Repeat RCA injection revealed normal flow with no evidence of air bubbles (Figure 1B). The incidence of Coronary air embolism is 0.1-0.3% and may prove fatal. The most efficacious means of dealing with it is prevention and fastidious aspiration and flushing of catheters between equipment exchanges.
