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Embolisation of the Coronary Arterial Tree with Thick Contrast Material during Coronary Angiography
Waleed M Ghaleb1, Abdelfatah Elasfar1, Mohsen Alarbash1
1Department of Cardiology, Almadinah Cardiac Centre, Almadinah, Saudi Arabia.
Insights
A rare case of contrast embolisation during coronary angiography caused a patient
Area of Science:
- Cardiology and Interventional Radiology
Background:
- Acute myocardial infarction requires timely intervention, often involving coronary angiography.
- Complications during procedures like percutaneous coronary intervention can be life-threatening.
Observation:
- A 58-year-old male undergoing primary PCI for inferior STEMI experienced sudden collapse.
- The patient presented with severe hypotension and bradycardia during the procedure.
- Symptoms were suspected to be caused by accidental embolisation of the left coronary system.
Findings:
- The cause of collapse was attributed to abnormally thick contrast material.
- Investigation revealed the contrast agent in the bottle was unusually viscous.
- This represents a rare instance of contrast material embolisation.
Implications:
- Accidental contrast embolisation is a potentially fatal but preventable complication.
- Careful quality control of contrast media is crucial during interventional procedures.
- Awareness of this rare event is important for interventional cardiologists and radiologists.
Abstract:
A 58-year male was referred to our centre with an acute inferior ST elevation myocardial infarction (STEMI). During the primary percutaneous coronary intervention, he suddenly collapsed with severe hypotension and severe bradycardia. The symptoms were attributed to an accidental embolisation of his left coronary system with the thick contrast material. When the remaining contrast in the bottle was investigated, it contained abnormally thick contrast material. This is a rare case of contrast embolisation, which is completely preventable but fatal, if undetected. Key Words: Coronary angiography, Contrast material, Contrast embolisation.
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