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.