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Coronary Angiography During Ex-Situ Heart Perfusion in a Porcine Model

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Discrepancy between coronary angiography and autopsy finding.

Till Saxer¹, Karim Burkhardt, Karim Bendjelid

¹Intensive Care Unit, Geneva University Hospitals, Geneva, Switzerland.

The American Journal of Forensic Medicine and Pathology

|April 14, 2010

Summary

This summary is machine-generated.

A patient with septic shock and acute renal failure showed no coronary artery lesions on angiography, yet autopsy revealed significant stenosis. This highlights potential diagnostic limitations in critically ill patients.

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Area of Science:

Cardiology
Nephrology
Critical Care Medicine

Background:

Septic shock can lead to multi-organ dysfunction, including acute kidney injury.
Myocardial infarction is a concern in critically ill patients, necessitating diagnostic evaluation.
Contrast-induced nephropathy is a risk in patients with renal impairment.

Observation:

A 71-year-old man presented with septic shock and acute renal failure.
Coronary cineangiography was performed to rule out myocardial infarction, using minimal contrast to prevent nephropathy.
Angiography revealed no significant coronary lesions.

Findings:

Autopsy demonstrated severe stenosis in the coronary arteries.
There was a discrepancy between angiographic findings and post-mortem examination.
The patient's septic shock and acute renal failure may have influenced diagnostic accuracy.

Implications:

This case underscores the potential for false-negative results in coronary angiography in critically ill patients with renal compromise.
It emphasizes the importance of considering autopsy findings in understanding diagnostic limitations.
Further research may be needed to optimize cardiac evaluation in septic shock patients with acute kidney injury.