Interventricular septum hematoma during cineventriculography

Intraseptal hematoma and subsequent myocardial infarction due to accidental contrast agent deposition complicating diagnostic cineventriculography is a previously undescribed complication of angiography. A 61 year old man was admitted at intensive care unit because of unstable angina pectoris 1 hour...

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Bibliographic Details
Published in:Cardiovascular ultrasound 2008-01, Vol.6 (1), p.4-4, Article 4
Main Authors: Grohmann, Andrea, Elgeti, Thomas, Eddicks, Stephan, Knebel, Fabian, Rutsch, Wolfgang, Melzer, Christoph, Baumann, Gert, Borges, Adrian C
Format: Article
Language:English
Subjects:
Cardiac Catheterization - adverse effects
Case Report
Contrast Media - administration & dosage
Contrast Media - adverse effects
Echocardiography, Stress
Electrocardiography
Heart Septal Defects, Ventricular - diagnostic imaging
Heart Septal Defects, Ventricular - etiology
Heart Septal Defects, Ventricular - therapy
Hematoma - etiology
Hematoma - therapy
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Myocardial Infarction - etiology
Myocardial Infarction - therapy
Radiography
Stents
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Summary:Intraseptal hematoma and subsequent myocardial infarction due to accidental contrast agent deposition complicating diagnostic cineventriculography is a previously undescribed complication of angiography. A 61 year old man was admitted at intensive care unit because of unstable angina pectoris 1 hour after coronary angiography. Transthoracic contrast echocardiography showed a non-perfused area in the middle of interventricular septum with an increase of thickening up to 26 mm. Review of cineventriculography revealed contrast enhancement in the interventricular septum after contrast medium injection and a dislocation of the pigtail catheter tip. Follow up by echocardiography and MRI showed, that intramural hematoma has resolved after 6 weeks. After 8 weeks successful stent implantation in LAD was performed and after 6 month the patient had a normal LV-function without ischemic signs or septal thickening demonstrated by stressechocardiography. A safe and mobile position of the pigtail catheter during ventriculography in the middle of the LV cavity should be ensured to avoid this potentially life-threatening complication. For assessment and absolute measurement of intramural hematoma contrast-enhanced echocardiography is more feasible than MRI and makes interchangeable results.
ISSN:1476-7120
1476-7120
DOI:10.1186/1476-7120-6-4