Emergency management - Type IV: Epicardial segment

Leaking into another cardiovascular cavity

A Type IV coronary perforation involves a leak into another cardiovascular cavity / cavity spilling.


Management algorithm

Management of a Type IV coronary perforation is similar to a Type III perforation. However, the blood leaks into another cardiovascular cavity (often ventricle or coronary vein). As such the symptoms are usually that of a new shunt rather than haemodynamic compromise due to a new pericardial effusion. Therefore Type IV coronary perforations tend to be better tolerated by the patient than Type III coronary perforations.

Coronary perforation algorithm: Type IV

Additional links

Case library

Consult the 1st Case study: a saphenous vein graft to right coronary artery


This case report does not reflect the opinion of PCR or PCRonline, nor does it engage their responsibility.