Key result
An acute right coronary artery dissection occurring during diagnostic cardiac catheterization resolved without clinical sequelae, and no abnormality was noted during subsequent valve replacement.
Case Report (n=1)
Iatrogenic coronary artery dissection during cardiac catheterization can occur without long-term clinical sequelae.
May support conservative management of select iatrogenic dissections; leaves open generalizability beyond case reports.
This report describes an acute right coronary artery dissection occurring during diagnostic cardiac catheterization. Following catheter manipulation in the vicinity of the aortic valve, the patient complained of mild chest discomfort and had transient electrocardiographic evidence of acute inferior wall myocardial infarction with runs of 2:1 atrioventricular block. Within 5 min, the EKG reverted to precatheterization appearance, and the patient was asymptomatic. Coronary angiography revealed a dissection of the proximal vessel without obstruction. The patient had no clinical sequelae while monitored in the intensive care unit. The patient underwent elective aortic and mitral valve replacement. The area of the dissection was directly visualized, and no abnormality was noted. We review the literature of spontaneous and iatrogenic coronary artery dissections with regard to pathology, diagnosis, and prognosis, and make recommendations for therapy.
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Meller et al. (1976) conducted a case report in Coronary artery dissection (n=1). Diagnostic cardiac catheterization was evaluated on Clinical sequelae. An acute right coronary artery dissection occurring during diagnostic cardiac catheterization resolved without clinical sequelae, and no abnormality was noted during subsequent valve replacement.
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