Methods (Differential diagnosis, investigations and treatment)
A complicated percutaneous coronary intervention was performed, during which the patient experienced renewed ventricular fibrillation after formation of a spontaneous embolus in the circumflex artery. The patient was connected to an extra corporal membrane oxygenation (ECMO) system for circulatory support, and stents were successfully inserted into the left coronary artery and LAD, resulting in restoration of TIMI-3 blood flow (Figure 1B). Later, the ejection fraction was estimated to approximately 10% and Troponin I measured to >1.5 million ng/l.
In the following days, the patient had unchanged severe heart failure with an ejection fraction remaining at 10% leading to insufficient organ perfusion and accumulation of lactic acid. The patient eventually developed multi-organ failure despite maximum treatment efforts, and ultimately the treatment was ceased, with the patient passing away shortly thereafter.