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Venous and arterial air embolism: a rare phenomenon with fatal consequences
  1. Jatan Shah1,
  2. Nasheena Jiwa1,
  3. Natasha Mamdani2,
  4. David Hill1
  1. 1Department of Internal Medicine, St Mary's Hospital, Waterbury, Connecticut, USA
  2. 2Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Jatan Shah, jatans7{at}


Air embolism is often an iatrogenic complication which may occur in venous or arterial circulation depending on the port of entry. We present two cases in which air embolism occurred in venous and arterial circulation after contrast medium injection (CMI) and coronary artery bypass graft (CABG) surgery, respectively. In one case, accumulation of air bubbles was observed in the pulmonary artery after CMI. This was attributed to inadvertent injection of air owing to improper connection of the injector and the catheter. The patient was managed with 100% oxygen in the Trendelenburg and left lateral decubitus position. Repeat imaging demonstrated resorption of the emboli. In another case, air was introduced during CABG in the left atrium and ventricle. Immediate suction of air was attempted however, the patient developed cardiogenic shock requiring vasopressors, and subsequently seizures and coma due to diffuse ischaemic stroke. The patient eventually expired.

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  • Contributors JS and NJ wrote the first concept of the manuscript. NM and DH critically revised it. After drafting the final version by JS, all authors approved it for publication.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.