Abstract

A 51-year-old manwith Ehlers-Danlos syndrome presented to our emergency department with the chief complaint of chest tightness. The patient was diagnosed with acute coronary syndrome, due to his crescendo pattern of typical angina without elevated troponin-I, which was managed with dual-antiplatelet agents and intravenous heparinization. However, the symptoms persisted, and coronary angiography was performed smoothly via the left radial artery with manual compression applied for wound closure. Nonetheless, a left arm hematoma with compartment syndrome due to delayed arterial leakage developed, which was treated with an emergency fasciotomy. Three days later, during general anesthesia for surgical wound closure, extensive subarachnoid hemorrhage occurred due to a remarkable fluctuation of blood pressure. The patient remained comatose in the following months. This case suggests that the undertaking of an endovascular procedure should be reserved for life-threatening scenarios to avoid any life-threatening complications for patients with Ehlers-Danlos Syndrome, especially the vascular type. Moreover, prolonged manual direct compression or trans-radial band may be mandatory for post-angiographic hemostasis.

Original languageEnglish
Pages (from-to)281-284
Number of pages4
JournalActa Cardiologica Sinica
Volume29
Issue number3
Publication statusPublished - May 2013

Fingerprint

Ehlers-Danlos Syndrome
Coronary Angiography
Compartment Syndromes
Endovascular Procedures
Radial Artery
Troponin I
Platelet Aggregation Inhibitors
Subarachnoid Hemorrhage
Acute Coronary Syndrome
Coma
Hemostasis
Hematoma
General Anesthesia
Hospital Emergency Service
Emergencies
Arm
Thorax
Blood Pressure
Wounds and Injuries

Keywords

  • Coronary angiography
  • Endovascular procedure
  • Vascular Ehlers-Danlos syndrome
  • Vascular rupture

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{fe1e680fdc5749f1969f5a1d9d31f905,
title = "A lethal complication after coronary angiography in a patient with ehlers-danlos syndrome",
abstract = "A 51-year-old manwith Ehlers-Danlos syndrome presented to our emergency department with the chief complaint of chest tightness. The patient was diagnosed with acute coronary syndrome, due to his crescendo pattern of typical angina without elevated troponin-I, which was managed with dual-antiplatelet agents and intravenous heparinization. However, the symptoms persisted, and coronary angiography was performed smoothly via the left radial artery with manual compression applied for wound closure. Nonetheless, a left arm hematoma with compartment syndrome due to delayed arterial leakage developed, which was treated with an emergency fasciotomy. Three days later, during general anesthesia for surgical wound closure, extensive subarachnoid hemorrhage occurred due to a remarkable fluctuation of blood pressure. The patient remained comatose in the following months. This case suggests that the undertaking of an endovascular procedure should be reserved for life-threatening scenarios to avoid any life-threatening complications for patients with Ehlers-Danlos Syndrome, especially the vascular type. Moreover, prolonged manual direct compression or trans-radial band may be mandatory for post-angiographic hemostasis.",
keywords = "Coronary angiography, Endovascular procedure, Vascular Ehlers-Danlos syndrome, Vascular rupture",
author = "Chen, {Yen Chou} and Chung, {Cheng Chih} and Kao, {Pai Feng} and Hsieh, {Ming Hsiung}",
year = "2013",
month = "5",
language = "English",
volume = "29",
pages = "281--284",
journal = "Acta Cardiologica Sinica",
issn = "1011-6842",
publisher = "Republic of China Society of Cardiology",
number = "3",

}

TY - JOUR

T1 - A lethal complication after coronary angiography in a patient with ehlers-danlos syndrome

AU - Chen, Yen Chou

AU - Chung, Cheng Chih

AU - Kao, Pai Feng

AU - Hsieh, Ming Hsiung

PY - 2013/5

Y1 - 2013/5

N2 - A 51-year-old manwith Ehlers-Danlos syndrome presented to our emergency department with the chief complaint of chest tightness. The patient was diagnosed with acute coronary syndrome, due to his crescendo pattern of typical angina without elevated troponin-I, which was managed with dual-antiplatelet agents and intravenous heparinization. However, the symptoms persisted, and coronary angiography was performed smoothly via the left radial artery with manual compression applied for wound closure. Nonetheless, a left arm hematoma with compartment syndrome due to delayed arterial leakage developed, which was treated with an emergency fasciotomy. Three days later, during general anesthesia for surgical wound closure, extensive subarachnoid hemorrhage occurred due to a remarkable fluctuation of blood pressure. The patient remained comatose in the following months. This case suggests that the undertaking of an endovascular procedure should be reserved for life-threatening scenarios to avoid any life-threatening complications for patients with Ehlers-Danlos Syndrome, especially the vascular type. Moreover, prolonged manual direct compression or trans-radial band may be mandatory for post-angiographic hemostasis.

AB - A 51-year-old manwith Ehlers-Danlos syndrome presented to our emergency department with the chief complaint of chest tightness. The patient was diagnosed with acute coronary syndrome, due to his crescendo pattern of typical angina without elevated troponin-I, which was managed with dual-antiplatelet agents and intravenous heparinization. However, the symptoms persisted, and coronary angiography was performed smoothly via the left radial artery with manual compression applied for wound closure. Nonetheless, a left arm hematoma with compartment syndrome due to delayed arterial leakage developed, which was treated with an emergency fasciotomy. Three days later, during general anesthesia for surgical wound closure, extensive subarachnoid hemorrhage occurred due to a remarkable fluctuation of blood pressure. The patient remained comatose in the following months. This case suggests that the undertaking of an endovascular procedure should be reserved for life-threatening scenarios to avoid any life-threatening complications for patients with Ehlers-Danlos Syndrome, especially the vascular type. Moreover, prolonged manual direct compression or trans-radial band may be mandatory for post-angiographic hemostasis.

KW - Coronary angiography

KW - Endovascular procedure

KW - Vascular Ehlers-Danlos syndrome

KW - Vascular rupture

UR - http://www.scopus.com/inward/record.url?scp=84878270812&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878270812&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:84878270812

VL - 29

SP - 281

EP - 284

JO - Acta Cardiologica Sinica

JF - Acta Cardiologica Sinica

SN - 1011-6842

IS - 3

ER -