title: Anterior ECG changes following iatrogenic dissection of the right coronary artery into the aortic root: exclusion of left coronary obstruction with transoesophageal echocardiography.
abstract: One of the most troublesome complications of percutaneous coronary intervention (PCI) or angiography is retrograde dissection of the artery into the aortic root. We report a case involving the right coronary artery (RCA) which was treated with prompt deployment of stents. Recurrent chest pain and ST segment elevation in V(2-4) mimicked the ECG appearance of acute anterior infarction and prompted concern that the dissection had extended to impair flow in the left coronary artery (LCA). Transoesophageal echocardiography (TOE) demonstrated that the aortic root dissection had been contained and that the LCA was not compromised.
authors.affiliation: Department of Cardiology, Prince Charles Hospital, Brisbane 4032, Australia.
authors.forename: Darryl
authors.initials: D
authors.lastname: Burstow
authors.forename: Karl
authors.initials: K
authors.lastname: Poon
authors.forename: Brendan
authors.initials: B
authors.lastname: Bell
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bett
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000293:injuries*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation; D011237:Predictive Value of Tests; D015607:Stents; D057772:Vascular System Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology