A double complication may yield a positive outcome: air embolism in a huge aneurysm

Abstract

Coronary artery air embolization is a rare event leading to catastrophic hemodynamic compromise within seconds after introduction of air within the coronary arteries. The management of massive air embolism should be extremely quick so as to prevent cardiac compromise. In this report, we present a case of massive air embolism in the left anterior descending artery during coronary angiography in a 47-year-old female with a history of smoking and hyperlipidemia, who was admitted due to typical exertional chest pain despite analgesic administration. Coronary angiography was performed for the patient which revealed huge aneurysm of the left main artery and total occlusion of LAD artery and air embolism in the LAD and left main artery. Blood flow was attained by passing a catheter through the LAD occlusion. The preexisting coronary artery disease in this patient has led to success in the management of massive coronary emboli. Massive coronary artery emboli are life threatening and require urgent management, however, some patients might benefit from coexisting coronary pathologies as in this case.