Iatrogenic Dissection of the Right Coronary Artery during Diagnostic Coronary Angiography: A Case Report

Abstract

Iatrogenic coronary dissection is a mechanical rupture of a coronary wall during coronary angiography or angioplasty. It is a rare but serious complication that can rapidly lead to the death of the patient. We report the case of a young 35 year old patient with only active smoking as a cardiovascular risk factor who presented during a coronary angiography for a STEMI a conduction disorder and hemodynamic instability revealing an iatrogenic dissection of the right coronary artery. Several predisposing factors for iatrogenic coronary artery dissection have been described in the literature, including female gender and deep intubation of the artery. It mainly involves the right coronary artery due to its specific anatomical characteristics. The diagnosis is made on coronary angiography. Management differs according to the haemodynamic state of the patient and the classification of the coronary dissection. Stenting, coronary artery bypass grafting or even conservative treatment may be proposed.