Korean Circ J.  2007 Jul;37(7):334-336. 10.4070/kcj.2007.37.7.334.

A Case of Coronary Air Embolism of the Left Coronary Arteries that Manifested as Cardiogenic Shock

• Yang HS
• Kim JY
• Moon SW
• Jung JH
• Kim DH
• Oh YS
• Jo JH
• Jeong MH

• KMID: 2227061
• DOI: http://doi.org/10.4070/kcj.2007.37.7.334

Abstract

Coronary air embolism remains a serious complication of coronary catheterization despite performing careful procedure to prevent this. We report here on a case of massive coronary air embolism that was complicated by cardiogenic shock in a 52-year-old male patient with angina pectoris. The patient had a stenosis in the middle left anterior descending artery (LAD) and percutaneous coronary intervention (PCI) was planned for the LAD lesion. During PCI, inadvertent manipulation of a pressure line induced massive air embolism in both proximal left coronary arteries, and this manifested as cardiogenic shock. The patient recovered after supportive measures and successive intracoronary injections of nitroglycerin and then he eventually underwent successful PCI.

Keyword

Embolism; Shock; Angioplasty

MeSH Terms

Angina Pectoris
Angioplasty
Arteries
Catheterization
Catheters
Constriction, Pathologic
Coronary Vessels*
Embolism
Embolism, Air*
Humans
Male
Middle Aged
Nitroglycerin
Percutaneous Coronary Intervention
Shock
Shock, Cardiogenic*
Nitroglycerin

Figure

• 

  Fig. 1 Diagnostic angiogram of the left coronary artery. There was a critical stenosis at the mid portion of left anterior descending (LAD) artery.

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  Fig. 2 Coronary air embolism. Air columns were interrupting the coronary flow at both proximal portions of the left anterior descending (LAD) and left circumflex (LCX) arteries (arrows).

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  Fig. 3 Follow-up angiogram after the initial supportive treatments (including inotropic agents) showed no significant improvement of the air embolism.

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  Fig. 4 Final angiogram. After the patient was successfully resuscitated from the shock state, a stent was implanted at the lesion site.

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