PMID- 37378096
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230701
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 5
DP  - 2023 May
TI  - Post-surgical External Coronary Artery Compression: A Rare Cause of ST Elevation 
      Myocardial Infarction.
PG  - e39075
LID - 10.7759/cureus.39075 [doi]
LID - e39075
AB  - Iatrogenic ST elevation myocardial infarction (STEMI) after aortic valve surgery 
      is a rare complication. Myocardial infarction (MI) due to mediastinal drain tube 
      compression on the native coronary artery is also seen rarely. We present a case 
      of ST elevation inferior myocardial infarction due to post-surgical drain tube 
      placed after aortic valve replacement compressing on the right-sided posterior 
      descending artery (rPDA). A 75-year-old female presented with exertional chest 
      pain and was found to have severe aortic stenosis (AS). After a normal coronary 
      angiogram and proper risk stratification, the patient underwent surgical aortic 
      valve replacement (SAVR). One day after surgery in the post-operative area, the 
      patient was complaining about central chest pain suggestive of anginal pain. 
      Electrocardiogram (ECG) revealed that she has ST elevation myocardial infarction 
      in the inferior wall. Immediately, she was taken to the cardiac catheterization 
      laboratory, which revealed that she has occlusion of the posterior descending 
      artery due to compression by a post-operative mediastinal chest tube. All 
      features of myocardial infarction resolved after simple manipulation of the drain 
      tube. The compression of the epicardial coronary artery after aortic valve 
      surgery is very unusual. There are a few cases of other coronary artery 
      compression due to mediastinal chest tube, but posterior descending artery 
      compression causing ST elevation inferior myocardial compression is unique. 
      Though rare, we need to be vigilant about mediastinal chest tube compression, 
      which can cause ST elevation myocardial infarction after cardiac surgery.
CI  - Copyright (c) 2023, Alam et al.
FAU - Alam, Md Mashiul
AU  - Alam MM
AD  - Internal Medicine, Bridgeport Hospital, Bridgeport, USA.
FAU - Azrin, Michael
AU  - Azrin M
AD  - Interventional Cardiology, University of Connecticut Health Center, Farmington, 
      USA.
FAU - Adeel, Yasir
AU  - Adeel Y
AD  - Cardiology, University of Connecticut Health Center, Farmington, USA.
LA  - eng
PT  - Case Reports
DEP - 20230516
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10292023
OTO - NOTNLM
OT  - chest tube
OT  - coronary artery occlusion
OT  - iatrogenic myocardial infarction
OT  - st elevation myocardial infarction (stemi)
OT  - surgical aortic valve replacement (savr)
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/06/28 13:09
MHDA- 2023/06/28 13:10
PMCR- 2023/05/16
CRDT- 2023/06/28 09:28
PHST- 2023/05/16 00:00 [accepted]
PHST- 2023/06/28 13:10 [medline]
PHST- 2023/06/28 13:09 [pubmed]
PHST- 2023/06/28 09:28 [entrez]
PHST- 2023/05/16 00:00 [pmc-release]
AID - 10.7759/cureus.39075 [doi]
PST - epublish
SO  - Cureus. 2023 May 16;15(5):e39075. doi: 10.7759/cureus.39075. eCollection 2023 
      May.