<- Home <- Arhive <- Vol. 26, Issue 4, December 2018

Rom J Leg Med26(4)369-373(2018)
© Romanian Society of Legal Medicine

Fatal coronary artery dissection caused by a diagnostic coronary catheterization: a case report and review of literature

S. F. Iannaccone, D. Sopková, M. Dinič, D. Farkaš

Abstract: In this paper we present the autopsy findings of a 40-year-old woman who was hospitalized for stenocardia, where she underwent coronary arteriography. Based on the negative finding of coronary obstruction the woman was given diagnosis of Prinzmetal angina, and was discharged the next day. Three days after this event she was admitted to the hospital for abdominal pain with suspicion of hemoperitoneum due to ruptured ectopic pregnancy. Revision surgery revealed the source of bleeding to be from splenic hilar vessels; splenectomy with distal pancreatectomy was performed. Even though the postoperative course was without major complications, the patient died on the fourth day of hospitalization. After obtaining additional information, it was discovered that the woman was a participant in a car accident one month prior to the first hospitalization, while after this event she was in a good health, and for the time period until hospitalization she didn't experience any evident symptoms of trauma. Autopsy revealed an intimal tear with a dissection of the left main coronary artery and its branches, which resulted in the development of myocardial infarction and led to the death of the patient.
Keywords: iatrogenic coronary artery dissection, intimal tear, myocardial infarction, coronary arteriography, autopsy.

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