Unusual Gastric Contrast Extravasation After Coronary Angiography

A 79-year-old woman presented with new-onset heart failure. She had pleural effusion, pericardial effusion, and an ejection fraction of 35% on echocardiogram. Her coronary angiogram revealed mild coronary artery disease (CAD). However, initially unexplained extravasation of the contrast was also seen in the cranial view during angiogram. The decision was made to medically manage CAD, but she remained tachycardic, with borderline low blood pressure. After a series of complications and tests, clearance of contrast from the stomach was confirmed. This represents an unusual case in which fluoroscopy revealed active gastric bleeding with contrast extravasation during coronary angiography.