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Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation Myocardial Infarction

Iatrogenic ST elevation myocardial infarction (STEMI) after aortic valve surgery is a rare complication. Myocardial infarction (MI) due to mediastinal drain tube compression on the native coronary artery is also seen rarely. We present a case of ST elevation inferior myocardial infarction due to pos...

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Detalles Bibliográficos
Autores principales: Alam, Md Mashiul, Azrin, Michael, Adeel, Yasir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292023/
https://www.ncbi.nlm.nih.gov/pubmed/37378096
http://dx.doi.org/10.7759/cureus.39075
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author Alam, Md Mashiul
Azrin, Michael
Adeel, Yasir
author_facet Alam, Md Mashiul
Azrin, Michael
Adeel, Yasir
author_sort Alam, Md Mashiul
collection PubMed
description Iatrogenic ST elevation myocardial infarction (STEMI) after aortic valve surgery is a rare complication. Myocardial infarction (MI) due to mediastinal drain tube compression on the native coronary artery is also seen rarely. We present a case of ST elevation inferior myocardial infarction due to post-surgical drain tube placed after aortic valve replacement compressing on the right-sided posterior descending artery (rPDA). A 75-year-old female presented with exertional chest pain and was found to have severe aortic stenosis (AS). After a normal coronary angiogram and proper risk stratification, the patient underwent surgical aortic valve replacement (SAVR). One day after surgery in the post-operative area, the patient was complaining about central chest pain suggestive of anginal pain. Electrocardiogram (ECG) revealed that she has ST elevation myocardial infarction in the inferior wall. Immediately, she was taken to the cardiac catheterization laboratory, which revealed that she has occlusion of the posterior descending artery due to compression by a post-operative mediastinal chest tube. All features of myocardial infarction resolved after simple manipulation of the drain tube. The compression of the epicardial coronary artery after aortic valve surgery is very unusual. There are a few cases of other coronary artery compression due to mediastinal chest tube, but posterior descending artery compression causing ST elevation inferior myocardial compression is unique. Though rare, we need to be vigilant about mediastinal chest tube compression, which can cause ST elevation myocardial infarction after cardiac surgery.
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spelling pubmed-102920232023-06-27 Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation Myocardial Infarction Alam, Md Mashiul Azrin, Michael Adeel, Yasir Cureus Cardiac/Thoracic/Vascular Surgery Iatrogenic ST elevation myocardial infarction (STEMI) after aortic valve surgery is a rare complication. Myocardial infarction (MI) due to mediastinal drain tube compression on the native coronary artery is also seen rarely. We present a case of ST elevation inferior myocardial infarction due to post-surgical drain tube placed after aortic valve replacement compressing on the right-sided posterior descending artery (rPDA). A 75-year-old female presented with exertional chest pain and was found to have severe aortic stenosis (AS). After a normal coronary angiogram and proper risk stratification, the patient underwent surgical aortic valve replacement (SAVR). One day after surgery in the post-operative area, the patient was complaining about central chest pain suggestive of anginal pain. Electrocardiogram (ECG) revealed that she has ST elevation myocardial infarction in the inferior wall. Immediately, she was taken to the cardiac catheterization laboratory, which revealed that she has occlusion of the posterior descending artery due to compression by a post-operative mediastinal chest tube. All features of myocardial infarction resolved after simple manipulation of the drain tube. The compression of the epicardial coronary artery after aortic valve surgery is very unusual. There are a few cases of other coronary artery compression due to mediastinal chest tube, but posterior descending artery compression causing ST elevation inferior myocardial compression is unique. Though rare, we need to be vigilant about mediastinal chest tube compression, which can cause ST elevation myocardial infarction after cardiac surgery. Cureus 2023-05-16 /pmc/articles/PMC10292023/ /pubmed/37378096 http://dx.doi.org/10.7759/cureus.39075 Text en Copyright © 2023, Alam et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Alam, Md Mashiul
Azrin, Michael
Adeel, Yasir
Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation Myocardial Infarction
title Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation Myocardial Infarction
title_full Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation Myocardial Infarction
title_fullStr Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation Myocardial Infarction
title_full_unstemmed Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation Myocardial Infarction
title_short Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation Myocardial Infarction
title_sort post-surgical external coronary artery compression: a rare cause of st elevation myocardial infarction
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292023/
https://www.ncbi.nlm.nih.gov/pubmed/37378096
http://dx.doi.org/10.7759/cureus.39075
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