Large atherosclerotic plaque related severe right coronary artery dissection during coronary angiography

Int J Cardiovasc Imaging. 2006 Jun-Aug;22(3-4):321-5. doi: 10.1007/s10554-005-9036-9. Epub 2005 Nov 30.

Abstract

Catheter-induced coronary artery dissection and occlusion is a rare but serious complication of diagnostic cardiac angiography. A 50 year-old man presented with unstable angina. ECG, exceptional of bradycardia, was normal (57 beat/min). Selective coronary angiography demonstrated 98% narrowing in the mid-portion of the left anterior descending coronary artery (LAD). During the right coronary angiography, following catheter manipulation in the vicinity of the aortic valve, the patient complained of severe chest discomfort, and he had electrocardiographic evidence of acute inferior wall myocardial infarction. Right coronary artery (RCA) was free of the significant obstruction, and it was observed to be having a dominant artery with a spiral dissection (NHLBI Grade IV) located between ostium and the proximal portion of the posterior descending and posterolateral artery bifurcation. The patient was immediately operated with off-pump coronary artery bypass surgery. Consequently, iatrogenic right coronary dissection that is a very rare condition as a cause of myocardial infarction, is discussed in this case report.

Publication types

  • Case Reports

MeSH terms

  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / etiology*
  • Aortic Dissection / surgery
  • Coronary Aneurysm / diagnostic imaging
  • Coronary Aneurysm / etiology*
  • Coronary Aneurysm / surgery
  • Coronary Angiography / adverse effects*
  • Coronary Artery Bypass, Off-Pump
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / surgery
  • Electrocardiography
  • Endarterectomy, Carotid
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / surgery