# A rare case of right coronary artery dissection during routine left heart catheterization

## TL;DR

A rare case of right coronary artery dissection during a routine heart catheterization procedure is reported and successfully treated with stenting.

## Contribution

This paper presents a rare clinical case of catheter-induced right coronary artery dissection with propagation to the aortic root.

## Key findings

- Catheter-induced right coronary artery dissection occurred during a routine left heart catheterization in a 68-year-old female.
- The dissection propagated towards the aortic root and was successfully managed with stenting and watchful waiting.
- Timely recognition and intervention are critical for optimal outcomes in such rare cases.

## Abstract

Percutaneous coronary intervention (PCI) is an effective method for coronary revascularization, however, alongside its benefits, it can be accompanied by complications. Catheter induced coronary artery dissection (CICAD) is rare and the consequences can be devastating if left untreated. The incidence has been reported to be as low as 0.1%. Also, propagation of the dissection to the aortic root remains uncommon. The mechanism of dissection is related to mechanical injury to the arterial wall during manipulation with the catheter or wire. It may also occur due to injection of contrast, stenting or balloon dilation. Timely recognition is important in these cases to facilitate optimal patient outcomes which is usually accomplished with stenting. Herein, we report a rare case of a 68-year-old female with multivessel coronary artery disease who presented for routine left heart catheterization and developed catheter induced right coronary artery (RCA) dissection with propagation towards the aortic root which was treated with stenting and watchful waiting.