ABSTRACT
Stent Entrapment is a rare complication of Percutaneous Coronary Intervention if left in situ may cause intracoronary or systemic embolization, thrombus formation, emergent coronary artery bypass graft surgery, or death. We here present a case of 2 unexpanded Drug eluting stent entrapment during the procedure leading to hemodynamic instability and Its treatment using stent crushing as a life-saving procedure.
ABSTRACT
Coronary air embolism is a dreadful complication of cardiac intervention despite careful prevention. In literature reported complications of coronary air embolism ranges from clinically non significant events to cardiogenic shock, myocardial infarction and death. We report a case of massive coronary air embolism in right coronary artery, which results in hypotension and complete heart block in a 33 -year-old female undergoing elective closure of atrial septal defect (ASD) by percutaneous transcatheter intervention. The patient stabilized after timely measures like oxygen support, dopamine infusion, cardiac compression and repeated bolus injection of heparinized saline. She then underwent successful percutaneous ASD device closure.
ABSTRACT
Arrhythmias can complicate the course of patients with ST-elevation myocardial infarction. These arrhythmias can include both tachyarrhythmias and bradyarrhythmias. Tachyarrhythmias range from Ventricular premature complexes to life-threatening ventricular tachycardia/ fibrillation. Bradyarrhythmias range from sinus bradycardia to complete heart block. These arrhythmias have the ability to provoke hemodynamic consequences and increase mortality. Tachyarrhythmias are more common with Anterior wall myocardial infarction and bradyarrhythmias are more common with Inferior wall myocardial infarction. We report a case of Mobitz Type 1 (Wenkebach) second-degree atrioventricular block in a patient with Anterior wall myocardial infarction. Angiography showed a significant lesion in Left anterior descending artery, after the first septal and diagonal branch. After the successful percutaneous coronary intervention, this second degree AV block reverted to first degree AV block. To the best of our knowledge, there is no case report describing this association separately.
ABSTRACT
Coronary artery anomalies occur in 1.3-5.6% of patients undergoing coronary arteriography. An anomalous origin of LCX from right coronary sinus is the most common congenital variant. It is usually considered “benign” since it is not known to predispose individuals to sudden cardiac death. Such vessels are particularly predisposed to atherosclerotic disease in their proximal portion, due to the acute angulation of its origin from the aorta and its posterior retro aortic course. We present a case of 55 years old female admitted with acute coronary syndrome. Coronary angiogram showed the anomalous origin of the left circumflex artery from right coronary sinus. This artery had a significant lesion which was successfully stented with a drug-eluting stent.
ABSTRACT
Background: Congenital lipoid adrenal hyperplasia presents with adrenal insufficiency and sex reversal in 46XY genetic males. Case characteristics: Two patients (46 XY karyotype), one having ambiguous genitalia and other having female external genitalia, presented with adrenal crisis at 6 months and 4 weeks of age, respectively. Observation: Steroidogenic Acute Regulatory Protein gene sequencing revealed homozygous mutations in both patients. Outcome: Treatment with hydrocortisone and fludrocortisone resulted in marked improvement . Message: Congenital lipoid adrenal hyperplasia should be considered in infants having female or ambiguous genitalia, and presenting with adrenal insufficiency.