Lateral ST-elevation myocardial infarction from systemic air embolism after CT guided lung biopsy.

Autor: Htay AM; Department of Diving and Hyperbaric Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.; Corresponding author: Dr Aung Myo Htay, Department of Diving and Hyperbaric Medicine, Royal Hobart Hospital, 48 Liverpool Street, Hobart, Tasmania 7000, Australia, htay.aung@ths.tas.gov.au., Wilson E; Department of Diving and Hyperbaric Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Jazyk: angličtina
Zdroj: Diving and hyperbaric medicine [Diving Hyperb Med] 2024 Sep 30; Vol. 54 (3), pp. 233-236.
DOI: 10.28920/dhm54.3.233-236
Abstrakt: Systemic air embolism is a rare but potentially life-threatening complication of computed tomography (CT)-guided lung biopsy. The largest lung biopsy audits report an incidence rate of approximately 0.061% for systemic air embolism, with a mortality rate of 0.07-0.15%. A prompt diagnosis with high index of suspicion is essential, and hyperbaric oxygen treatment (HBOT) is the definitive management. We report the case of a 44-year-old lady who developed a lateral ST elevation myocardial infarction from coronary artery air embolism following CT-guided lung biopsy for evaluation of a left lung lesion. The biopsy was performed in the right lateral decubitus position, and the patient reported chest pain after coughing during the procedure. The clinician decided to proceed, taking four biopsy samples as no pneumothorax was identified in the intraprocedural CT image. The patient was noted to have hypotension with ongoing chest pain post-procedure. Resuscitative measures were taken to stabilise her haemodynamics, and she was successfully treated with HBOT with total resolution of air embolism. She developed a left sided pneumothorax post-treatment and needed intercostal chest drain insertion. The left lung fully re-expanded, and the patient was discharged home after day two of admission.
Competing Interests: The authors report no conflicts of interest in this work.
(Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)
Databáze: MEDLINE