PT  - JOURNAL ARTICLE
AU  - Sudeep Kumar
AU  - Alok Nath
AU  - Satyajeet Singh
AU  - Tanuj Bhatia
AU  - Aditya Kapoor
TI  - An Unusual Complication During Bronchoscopy: Hypotension, Global ST Segment Elevation, and Acute Severe Left Ventricular Systolic Dysfunction
AID  - 10.4187/respcare.02318
DP  - 2013 Sep 01
TA  - Respiratory Care
PG  - e111--e115
VI  - 58
IP  - 9
4099  - http://rc.rcjournal.com/content/58/9/e111.short
4100  - http://rc.rcjournal.com/content/58/9/e111.full
AB  - Bronchoscopy is widely performed and generally considered safe. Cardiac complications during bronchoscopy are uncommon, and usually occur in elderly patients with coexistent coronary artery disease, hypertension, or severely impaired pulmonary function and resting hypoxemia. We report a patient who developed sudden onset restlessness, chest discomfort, hypotension, global ST elevation in multiple electrocardiogram leads, and acute severe left ventricular systolic dysfunction during a bronchoscopic transbronchial lymph node biopsy. Differential diagnosis included a massive myocardial infarction, apical ballooning (Tako-tsubo syndrome), or coronary vasospasm. The electrocardiogram changes resolved spontaneously, and a coronary angiogram 48 hours later revealed normal coronary artery anatomy and normal LV function. The patient made an uneventful recovery. It is important for physicians to be aware of such unusual complications to be able to appropriately manage these patients in clinical practice.