Perforation of normal left ventricle by contrast jet during left ventricular angiogram by hand injection using TIG OPTITORQUE catheter – A rare complication

A 70-year-old hypertensive female presented with exertional angina (NYHA class II). Clinical cardiac examination and electrocardiogram was normal. Echocardiography was normal except grade I diastolic dysfunction. Coronary angiogram revealed non-obstructive coronary artery disease. Left ventricular angiogram was performed by hand injection using 5F TIG OPTITORQUE catheter (Terumo Corporation, NJ.), which was complicated by myocardial staining, myocardial perforation and pericardial effusion. Patient was managed conservatively and discharged on fourth day with stable hemodynamic condition. Echocardiogram performed on tenth day of event revealed resolution of pericardial effusion.