Critical Care and Shock

Coronary air embolism: What should we do?

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Background: Coronary air embolism continues to be a known complication of coronary catheterization despite the notable focus on prevention.

Case presentation: Here, we report a case of coronary air embolism (CAE) of the right coronary artery (RCA) during coronary angiography (CAG). The patient developed unstable hemodynamics with a sign of ST elevation during the event. The patient recovered after simultaneous management, including oxygen, an injection of norepinephrine, atropine, morphine, and intracoronary aspiration, which successfully resolved the air emboli.

Conclusion: If a patient appears with chest pain, hypotension, or arrhythmias, clinicians should consider CAE as a differential diagnosis and perform CAG to confirm the existence of a distinct bubble.

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