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- Title
Unusual cause of acute myocardial infarction after surgery for intramural hematoma of the ascending aorta.
- Authors
Predescu, Lucian; Mereuta, Adrian; Beladan, Carmen; Popa, Aura; Iosifescu, Andrei; Paunescu, Alina; Ginghina, Carmen; Deleanu, Dan
- Abstract
Intramural hematoma of the ascending aorta has a poor prognosis if it is not promptly diagnosed and treated. Even with surgical correction, postoperative management is feared because of its complicated course. We present a case of a 58 years old male patient admitted with intramural hematoma of the ascending aorta complicated with significant pericardial effusion. The patient was treated by surgery (the ascending aorta and aortic hemi-arch was replaced with a collagen-sealed Dacron prostheses). Early after surgery the patient developed acute myocardial infarction. Emergent coronary angiography demonstrated a pronounced spasm of the distal portion of the right coronary artery, apparently related to compression of this vessel by a chest drain tube. The pericardial drainage tube was extracted and intracoronary nitroglycerine was administrated with the disappearance of coronary stenosis and normalizing of coronary blood flow. This case is particular because it draws attention to the fact that mechanical compression of coronary artery by pericardial drainage tube may trigger an exaggerated vasomotor response, leading to severe coronary artery spasms and to the importance of correct placement of drainage tubes in the pericardium.
- Subjects
MYOCARDIAL infarction; HEMATOMA
- Publication
Romanian Journal of Cardiology, 2016, Vol 26, Issue 3, p325
- ISSN
1220-658X
- Publication type
Article