title: [Right coronary air embolism secondary to bowel infarction: a case report].
abstract: An 81-year-old man with broad cerebral infarction presented with coronary air embolism secondary to bowel infarction and developed cardiogenic shock. Electrocardiography revealed ST elevation in the inferior leads and complete atrioventricular block with atrial fibrillation. Emergent angiography showed total occlusion of the right coronary artery without apparent thrombi. A multifunctional probe catheter was inserted into the right coronary artery for selective angiography. A moderate amount of air was aspirated from the catheter. The diagnosis was coronary air embolism. Coronary flow was restored after aspiration and normal saline flushing. Computed tomography showed massive portal venous gas. Emergent laparotomy disclosed broad bowel necrosis. The coronary air emboli may have originated from the portal vein and passed through the intrahepatic (portal to hepatic) shunt and patent foramen ovale(paradoxical embolization).
authors.affiliation: Department of Cardiology, Kawasaki Saiwai Hospital Cardiovascular Center, Miyako-cho 39-1, Saiwai-ku, Kawasaki 212-0021.
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Etsuda
authors.forename: Akira
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Naohiro
authors.initials: N
authors.lastname: Hakamata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuda
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Yamauchi
authors.forename: Takako
authors.initials: T
authors.lastname: Akita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000209:etiology*; D004562:Electrocardiography; D004618:Embolism, Air / Q000175:diagnosis / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D007238:Infarction / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D007422:Intestines / Q000098:blood supply* / Q000473:pathology; D008297:Male; D009336:Necrosis; D012770:Shock, Cardiogenic / Q000209:etiology