Transient Lingual Ischemia Complicating Coronary Angiography

J INVASIVE CARDIOL 2019;31(3):E51. Key words: acute tongue ischemia, angiography, cardiac imaging

A 57-year-old woman underwent coronary angiography for non-typical chest pain syndrome. The procedure was performed via the right radial artery. At the end of the procedure, she complained of numbness at her mouth and tongue. Inspection revealed rightward deviation of the tongue and discoloration of the right anterior quadrant of the organ, consistent with acute tongue ischemia (Figure 1A). Signs and symptoms resolved spontaneously within 10 minutes (Figure 1B) and the procedure was otherwise uncomplicated. No significant coronary artery disease was revealed.

Acute tongue ischemia is a rare clinical entity, mostly associated with arteritis, circulatory shock, Raynaud’s disease, or carotid artery disease. Our patient remained hemodynamically stable throughout the procedure and had no prior history of symptoms compatible with systemic arteritis or Raynaud’s phenomenon.

Arterial embolism is a potential complication of coronary angiography and could theoretically affect the lingual circulation. However, the transient nature of the patient’s clinical signs and symptoms suggests vasospasm as the most likely underlying mechanism of lingual ischemia in this case.

From the Department of Cardiology, University Hospital of Heraklion, Crete, Greece.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.

The authors report that patient consent was provided for publication of the images used herein.

Manuscript accepted September 17, 2018.

Address for correspondence: Emmanouil Skalidis, MD, PhD, Associate Professor of Cardiology, University Hospital of Heraklion, Department of Cardiology, Voutes and Stavrakia, Heraklion, Crete, Greece, 71409. Email: skalides@uoc.gr