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.
Table of content
- Introduction Type IV
- Management algorithm
- Additional links
- Case library
- Post-procedural care
Introduction
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.

Case library
Consult the 1st Case study: a saphenous vein graft to right coronary artery
Disclaimer
This case report does not reflect the opinion of PCR or PCRonline, nor does it engage their responsibility.