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[Arterial gas embolism progressing to a massive stroke].

Authors: C, Soto-Sarrión; C, Poyatos; S, Isarria-Vidal; R, Faus-Cerdá; J M, Esteban-Hernández;

[Arterial gas embolism progressing to a massive stroke].

Abstract

Arterial gas embolism (AGE) is a main iatrogenic complication resulting from the use of invasive procedures. It is difficult to diagnose if it is not clinically suspected.A 67-year-old male patient, with a history of interventions involving a mitral prosthesis and a double aortocoronary bypass, who visited Emergency room with symptoms of a high temperature and general malaise. He was canalised peripherally and the electrocardiogram (ECG) showed an auricular fibrillation that had already been detected. While under observation he suffered a loss of consciousness, generalised hypotonia, conjugated gaze deviation towards the right, lower left facial paralysis and left Babinski positive. A new ECG showed ST segment elevation in V2-V5. A cranial computerised tomography (CAT) scan with no contrast revealed a number of serpiginous images caused by the presence of air in vascular structures. A second cranial CAT scan showed the disappearance of the visible air and signs of ischemic stroke in the territory of the right middle and posterior cerebral arteries and the left middle cerebral artery. Clinical-radiological findings suggested an AGE in the brain with massive stroke and acute myocardial infarct with similar causation.It is not clear what caused the air embolism in this patient but it can most probably be explained by air accidentally entering a peripheral vein. Carrying out an early cranial CAT scan can provide us with a diagnosis and a later CAT scan can evaluate the consequences of the embolism.

Keywords

Heart Valve Prosthesis Implantation, Male, Iatrogenic Disease, Myocardial Infarction, Infarction, Middle Cerebral Artery, Brain Ischemia, Infarction, Posterior Cerebral Artery, Fatal Outcome, Postoperative Complications, Atrial Fibrillation, Catheterization, Peripheral, Disease Progression, Embolism, Air, Humans, Mitral Valve, Coronary Artery Bypass, Emergencies, Tomography, X-Ray Computed, Aged

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Powered by OpenAIRE graph
Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Average
Top 10%
Average
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