A CASE OF SHOWER EMBOLISM USING IABP ON A PATIENT UNDERGOING HEMODIALYSIS WHO HAD ACUTE MYOCARDIAL INFORCTION

Abstract

A patient who was on hemodialysis had acute myocardial infarction. Direct PICA was performed and reperfusion of the stenotic artery was obtained. Serum CPK levels decreased and the patient, had been stable. Several days later, CPK and LDH increased again without significant increase of CPK-MB component. Restenosis was highly suspected and CAG was performed, however no restenosis nor extension were observed. IABP was used but circulatory failure progressed and the patient died eventually. The autopsy showed severe systemic atherosclerosis, hemorrhagic necrosis and cholesterine emboli of the intestine. This shower embolism may be caused by catheter manipulation and IABP use on patient with severe athrosclerosis.