Coronary Artery Air Embolism Following a Transbronchial Lung Biopsy

Abstract

Background. We experienced a case of right coronary artery (RCA) air embolism following a transbronchial lung biopsy (TBLB). Case. A 57 years old man complained of cough and dyspnea. He was treated with anti-biotics but his symptoms did not improve. Chest X-ray and computed tomography (CT) showed ground glass opacity in the bilateral lung field, so interstitial pneumonia was suspected. Bronchoalveolar lavage (BAL) and a TBLB were performed. During the procedure, there was no issues, but the patient was coughing a bit excessively. Immediately after TBLB, he reported left chest pain. An electrocardiogram (ECG) revealed ST-segment elevation. Chest CT showed the existence of air in the RCA, ascending aorta and left ventricle. We diagnosed him with air embolism of RCA following a TBLB. He was observed in the intensive-care unit, and the following day, chest CT showed the disappearance of air, and no issues with his cardiac function were noted on transthoracic echocardiography. Conclusion. Air embolism of the RCA following a TBLB is a very rare adverse event, but should receive close attention. Emphysematous changes in the lung and cough may be risk factors for air embolism.