Favorable outcome in a large left heart air embolism: lessons from an unusual complication of a noninvasive chest scan

Abstract

Objective: To report an unusual life-threatening complication of the performance of a computed tomographic (CT) scan of the chest.

Design: Case report.

Setting: University hospital.

Patient: An intubated patient with blunt thoracic trauma.

Intervention: Performance of a CT scan of the chest at full inspiration.

Main result: With air insufflation, a large left ventricular air embolism occurred as a consequence of an airway breach, revealed by the simultaneous existence of a mild bilateral anterior pneumothorax.

Conclusion: CT scan of the chest in patients at risk of airway breach (patients with acute respiratory distress syndrome, trauma patients) should first be performed at full expiration, not full inspiration.