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Published on: May 14, 2013
Life-Threatening Dynamic Coronary Obstruction in a Patient With Rhabdomyosarcoma Treated With Stenting
Mark Kheifets1, Nicholas Howell1, Inbar Nardi Agmon1
1Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Background:
Dynamic coronary obstruction is a rare and potentially lethal condition, which may cause an acute coronary syndrome (ACS).
Case Summary:
A young patient with metastatic rhabdomyosarcoma was transferred to our center's cardiac intensive care unit with a ventricular tachycardia (VT) storm. A cardiac mass was demonstrated on transthoracic echocardiography and computed tomography. Coronary angiography was performed owing to suspected compression of the coronary arteries. Dynamic obstruction in the left anterior descending artery (LAD) was demonstrated with the use of angiography and intravascular ultrasound. After successful ostial to mid-LAD stenting, there was no recurrence of VT episodes.
Discussion:
VT storm is a lethal condition that requires rapid diagnosis and treatment. Rarely, it can be caused by dynamic coronary obstruction.
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