Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery
Acute myocardial infarction (AMI) caused by severe stenosis of left main coronary artery (LMCA) presenting with cardiogenic shock and pulmonary edema during noncardiac surgery is uncommon, but a catastrophic event. A 77-year-old male with cholangiocarcinoma underwent hepatectomy. During the surgery,...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2021/5460816 |
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| author | Sakae Takenaka Takao Konishi Tomoya Sato Atsushi Tada Takuya Koizumi Yoshifumi Mizuguchi Takahide Kadosaka Ko Motoi Yuta Kobayashi Hirokazu Komoriyama Yoshiya Kato Miwa Sarashina Kazunori Omote Shingo Tsujinaga Takuma Sato Rui Kamada Kiwamu Kamiya Hiroyuki Iwano Toshiyuki Nagai Tatsuya Orimo Hirofumi Kamachi Akinobu Taketomi Toshihisa Anzai |
| author_facet | Sakae Takenaka Takao Konishi Tomoya Sato Atsushi Tada Takuya Koizumi Yoshifumi Mizuguchi Takahide Kadosaka Ko Motoi Yuta Kobayashi Hirokazu Komoriyama Yoshiya Kato Miwa Sarashina Kazunori Omote Shingo Tsujinaga Takuma Sato Rui Kamada Kiwamu Kamiya Hiroyuki Iwano Toshiyuki Nagai Tatsuya Orimo Hirofumi Kamachi Akinobu Taketomi Toshihisa Anzai |
| author_sort | Sakae Takenaka |
| collection | DOAJ |
| description | Acute myocardial infarction (AMI) caused by severe stenosis of left main coronary artery (LMCA) presenting with cardiogenic shock and pulmonary edema during noncardiac surgery is uncommon, but a catastrophic event. A 77-year-old male with cholangiocarcinoma underwent hepatectomy. During the surgery, he presented with cardiogenic shock, which did not respond to infusion administration or vasopressor. A transesophageal echocardiogram revealed anterior, septal, and lateral severe hypokinesia and impaired left ventricular function. Emergent coronary angiogram showed severe stenosis of LMCA. The patient underwent primary percutaneous coronary intervention (PCI) under the support of intra-aortic balloon pump, followed by extracorporeal membrane oxygenation. The chest roentgenogram showed pulmonary edema. Two days after PCI, he successfully underwent hepatectomy and bile duct resection. Early identification of the cause of hemodynamic instability during noncardiac surgery and invasive strategy are important for minimizing the myocardial injury and improving clinical outcomes in AMI of LMCA. |
| format | Article |
| id | doaj-art-a8eb5c56787b468cbfac200e7dabd72b |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-a8eb5c56787b468cbfac200e7dabd72b2025-02-03T05:43:47ZengWileyCase Reports in Cardiology2090-64042090-64122021-01-01202110.1155/2021/54608165460816Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac SurgerySakae Takenaka0Takao Konishi1Tomoya Sato2Atsushi Tada3Takuya Koizumi4Yoshifumi Mizuguchi5Takahide Kadosaka6Ko Motoi7Yuta Kobayashi8Hirokazu Komoriyama9Yoshiya Kato10Miwa Sarashina11Kazunori Omote12Shingo Tsujinaga13Takuma Sato14Rui Kamada15Kiwamu Kamiya16Hiroyuki Iwano17Toshiyuki Nagai18Tatsuya Orimo19Hirofumi Kamachi20Akinobu Taketomi21Toshihisa Anzai22Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Gastroenterological Surgery I, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Gastroenterological Surgery I, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Gastroenterological Surgery I, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanAcute myocardial infarction (AMI) caused by severe stenosis of left main coronary artery (LMCA) presenting with cardiogenic shock and pulmonary edema during noncardiac surgery is uncommon, but a catastrophic event. A 77-year-old male with cholangiocarcinoma underwent hepatectomy. During the surgery, he presented with cardiogenic shock, which did not respond to infusion administration or vasopressor. A transesophageal echocardiogram revealed anterior, septal, and lateral severe hypokinesia and impaired left ventricular function. Emergent coronary angiogram showed severe stenosis of LMCA. The patient underwent primary percutaneous coronary intervention (PCI) under the support of intra-aortic balloon pump, followed by extracorporeal membrane oxygenation. The chest roentgenogram showed pulmonary edema. Two days after PCI, he successfully underwent hepatectomy and bile duct resection. Early identification of the cause of hemodynamic instability during noncardiac surgery and invasive strategy are important for minimizing the myocardial injury and improving clinical outcomes in AMI of LMCA.http://dx.doi.org/10.1155/2021/5460816 |
| spellingShingle | Sakae Takenaka Takao Konishi Tomoya Sato Atsushi Tada Takuya Koizumi Yoshifumi Mizuguchi Takahide Kadosaka Ko Motoi Yuta Kobayashi Hirokazu Komoriyama Yoshiya Kato Miwa Sarashina Kazunori Omote Shingo Tsujinaga Takuma Sato Rui Kamada Kiwamu Kamiya Hiroyuki Iwano Toshiyuki Nagai Tatsuya Orimo Hirofumi Kamachi Akinobu Taketomi Toshihisa Anzai Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery Case Reports in Cardiology |
| title | Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery |
| title_full | Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery |
| title_fullStr | Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery |
| title_full_unstemmed | Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery |
| title_short | Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery |
| title_sort | acute myocardial infarction of the left main coronary artery presenting with cardiogenic shock and pulmonary edema during noncardiac surgery |
| url | http://dx.doi.org/10.1155/2021/5460816 |
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