[Right coronary air embolism secondary to bowel infarction: a case report].
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).
Etsuda
Hirokuni
H
Department of Cardiology, Kawasaki Saiwai Hospital Cardiovascular Center, Miyako-cho 39-1, Saiwai-ku, Kawasaki 212-0021.
Miyamoto
Akira
A
Hakamata
Naohiro
N
Fukuda
Masahiro
M
Yamauchi
Yasutaka
Y
Akita
Takako
T
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