Contrast-induced encephalopathy after coronary angioplasty in a patient with ST-elevation myocardial infarction

A 75-year-old man with a history of diabetes mellitus presented with chest pain. He was diagnosed with acute ST-elevation myocardial infarction. Emergent coronary angiography revealed proximal left anterior descending (LAD) artery occlusion. Primary percutaneous coronary intervention (PCI) was then performed. During aspiration thrombectomy, he went into cardiopulmonary arrest. Cardiopulmonary resuscitation (CPR) was started immediately. Recovery of spontaneous circulation was obtained after 7 min of CPR while PCI of the LAD was being performed simultaneously. A drug-eluting stent was deployed over the culprit lesion and the occluded artery was reperfused. After PCI, whole-body CT was performed because of transient haemodynamic instability. Non-contrast CT after PCI showed high-density areas in the cortex, putamen, caudate nucleus and subarachnoid space of the right cerebral hemisphere (figure 1A). No neurological symptoms were observed because the patient was intubated. CT imaging on hospital day 2 showed disappearance of the high-density areas (figure...
Source: Heart Asia - Category: Cardiology Authors: Tags: Images in cardiovascular medicine Source Type: research