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Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery

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Title: Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery
Authors: Takenaka, Sakae Browse this author
Konishi, Takao Browse this author
Sato, Tomoya Browse this author
Tada, Atsushi Browse this author
Koizumi, Takuya Browse this author
Mizuguchi, Yoshifumi Browse this author
Kadosaka, Takahide Browse this author
Motoi, Ko Browse this author
Kobayashi, Yuta Browse this author
Komoriyama, Hirokazu Browse this author
Kato, Yoshiya Browse this author
Sarashina, Miwa Browse this author
Omote, Kazunori Browse this author
Tsujinaga, Shingo Browse this author
Sato, Takuma Browse this author
Kamada, Rui Browse this author
Kamiya, Kiwamu Browse this author
Iwano, Hiroyuki Browse this author
Nagai, Toshiyuki Browse this author
Orimo, Tatsuya Browse this author
Kamachi, Hirofumi Browse this author
Taketomi, Akinobu Browse this author
Anzai, Toshihisa Browse this author →KAKEN DB
Issue Date: 14-Aug-2021
Publisher: Hindawi Publishing Corporation
Journal Title: Case Reports in Cardiology
Volume: 2021
Start Page: 5460816
Publisher DOI: 10.1155/2021/5460816
Abstract: 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.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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