Transient lateral rectus palsy associated with acute coronary syndrome treated with percutaneous coronary intervention: a case report

J Med Case Rep. 2023 Sep 13;17(1):389. doi: 10.1186/s13256-023-04124-4.

Abstract

Background: Patients who experience angina and acute myocardial infarction often receive diagnostic coronary angiography and percutaneous coronary intervention.

Case presentation: A 54-year-old Persian man with acute coronary syndrome was admitted to the hospital and underwent elective percutaneous coronary intervention. Two hours after the procedure, the patient experienced ophthalmoplegia and diplopia. The diagnosis was abducens nerve palsy resulting in transient lateral rectus palsy. The cause is presumed to have been an ischemic event affecting the unilateral abducens nerve. This could have occurred owing to the microembolism during the percutaneous coronary intervention, which resulted in left lateral rectus palsy. Within 1 month, the diplopia was relieved completely, and the physical examination was normal.

Conclusion: The occurrence of neuro-ophthalmic complications that may arise from percutaneous coronary intervention is extremely rare. To our knowledge, this is the second reported case of unilateral rectus palsy associated with percutaneous coronary intervention.

Keywords: Abducens nerve disease; Acute coronary syndrome; Case report; Complication; Percutaneous coronary intervention.

Publication types

  • Case Reports

MeSH terms

  • Abducens Nerve Diseases* / etiology
  • Acute Coronary Syndrome* / complications
  • Acute Coronary Syndrome* / therapy
  • Coronary Angiography
  • Diplopia / etiology
  • Humans
  • Male
  • Middle Aged
  • Paralysis
  • Percutaneous Coronary Intervention*