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[Right coronary air embolism secondary to bowel infarction: a case report]

Hirokuni Etsuda1, Akira Miyamoto, Naohiro Hakamata

  • 1Department of Cardiology, Kawasaki Saiwai Hospital Cardiovascular Center, Miyako-cho 39-1, Saiwai-ku, Kawasaki 212-0021.

Journal of Cardiology
|April 8, 2004
PubMed

Insights

A rare case of coronary air embolism occurred in an 81-year-old man due to bowel infarction. Prompt diagnosis and intervention restored coronary flow, highlighting a potential pathway from portal venous gas to cardiac events.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Radiology

Background:

  • A patient presented with cardiogenic shock and myocardial infarction.
  • Initial investigations revealed ST elevation and complete atrioventricular block.

Observation:

  • Coronary angiography showed complete occlusion of the right coronary artery without thrombi.
  • Aspiration via a catheter revealed air, leading to a diagnosis of coronary air embolism.
  • Computed tomography demonstrated extensive portal venous gas.

Findings:

  • Successful restoration of coronary blood flow was achieved through air aspiration and saline flushing.
  • The patient underwent emergent laparotomy revealing extensive bowel necrosis.

Implications:

  • This case suggests a potential pathophysiological pathway where portal venous gas can lead to coronary air embolism via intrahepatic shunting and patent foramen ovale.
  • Highlights the importance of considering paradoxical embolism in cases of unexplained coronary events with gastrointestinal pathology.

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