A 65-Year-Old Man with Coronary Artery Embolism and Acute Inferior Myocardial Infarction Following Cardioversion for Ventricular Tachycardia.

Abstract

BACKGROUND Cardioversion is a medical procedure aimed to convert abnormal rhythm to normal rhythm in hemodynamically unstable patients in ventricular tachycardia. The complications of cardioversion are mainly thromboembolism, with stroke being the most common complication. However, emboli can travel anywhere, including to the coronary arteries. In the literature, the complications highlighted are usually tailored towards atrial fibrillation. Indeed, acute embolic myocardial infarction following direct-current cardioversion of ventricular tachycardia has not been identified in the literature. This report describes a 65-year-old man with coronary artery embolism and acute inferior myocardial infarction following cardioversion for ventricular tachycardia. CASE REPORT A 65-year-old man with medical history of hypertension, chronic kidney disease, diabetes mellitus, dyslipidemia, and monomorphic ventricular tachycardia presented to the Emergency Department with monomorphic ventricular tachycardia not responding to conservative management; thus, electrical cardioversion was performed. He then developed embolic inferior wall myocardial infarction later in the day, confirmed with coronary angiogram and was treated conservatively according to patient comorbidities. CONCLUSIONS Embolic myocardial infarction following electrical cardioversion is rare, with only few cases reported in patients with atrial fibrillation. Proper diagnosis of this condition can help improve patient outcomes and reduce the rate of reoccurrence. To the best of our knowledge, this is the first case showing acute embolic myocardial infarction in a patient who underwent direct-current cardioversion for ventricular tachycardia.