Jailed Right Coronary Artery Presenting With Recurrent Pulseless Electrical Activity Arrest

Abstract

A 69-year-old woman post aortic valve replacement underwent circumflex artery stenting complicated by arrests from hypotension, bradycardia, and cardiogenic shock. Postmortem pathology showed chronic right coronary artery occlusion collateralized by the circumflex artery jailed by stenting. This case highlights the importance of defining coronary collaterals, suspecting late presenting coronary occlusion from aortic valve replacement, and recognizing the Bezold-Jarisch reflex.