Ventricular fibrillation during coronary angiography in a patient with left dominant coronary artery ectasia

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Biology

Background:

• Coronary artery ectasia (CAE) is defined as a dilation of the epicardial coronary arteries exceeding the diameter of adjacent normal segments.
• While infrequent, CAE is recognized as a significant risk factor for adverse cardiovascular events, including myocardial infarction and stroke.
• The underlying pathophysiology of CAE is complex and may involve genetic, inflammatory, and mechanical factors.

Observation:

• This report presents a unique case of a patient with left dominant coronary artery ectasia.
• The patient experienced an unexpected and previously undocumented complication during coronary angiography.
• Ventricular fibrillation (VF) occurred during the diagnostic procedure.

Findings:

• The occurrence of ventricular fibrillation during coronary angiography in a patient with CAE is a novel observation.
• This event highlights a potential, uncharacterized risk associated with CAE, particularly in left dominant patterns.
• The case underscores the importance of vigilance during invasive procedures in patients with CAE.

Implications:

• The findings suggest that coronary artery ectasia may be associated with a higher risk of sudden cardiac events than previously understood.
• Further research is warranted to elucidate the mechanisms linking CAE to arrhythmias like ventricular fibrillation.
• Clinicians should consider this potential complication when managing patients with coronary artery ectasia, especially during angiographic procedures.