The Medical Journal of Basrah University

Abstract

Coronary artery dissections with or without rupture is a rare but well-recognized complication of coronary angiography with a high morbidity and mortality rate.
We present a rare case of extensive Right Coronary Artery (RCA) dissection that occurred during diagnostic coronary angiography. The vessel dissected during the first injection of contrast agent which was extended spirally from proximal to distal segment. Hopefully the dissection had stented successfully and the patient was discharged after 48 hour of intensive monitoring.
In conclusion coronary artery dissection represents a unique complication of percutaneous coronary intervention and to small extent diagnostic coronary angiography and, if untreated, can lead to serious sequelae including abrupt vessel closure, periprocedural myocardial infarction, closure of major side branches, vessel perforation, tamponade and death. In the present era, coronary stents successfully treat most dissections, so that the risk of sustained vessel closure or the need for emergency bypass surgery due to a dissection is very rare.