Coronary artery winking sign' is a recently described angiographic sign of impending cardiac rupture..
Sometimes in post-infarction elderly patients when we do an angiographic shoot and winking sign is seen it is an indicator of myocardial rupture which is usually a fatal complication of myocardial infarction seen in 1-2 percent of the cases.
Coronary artery winking sign' is a recently described angiographic sign of impending cardiac rupture..
Sometimes in post-infarction elderly patients when we do an angiographic shoot and winking sign is seen it is an indicator of myocardial rupture which is usually a fatal complication of myocardial infarction seen in 1-2 percent of the cases.
Winking sign' is only incidentally detected when we happen to do an angiography in a post infarction patient who is likely to have a cardiac rupture in the next few minutes.
The sign is characterized by appearing and disappearing coronary artery during various phases of the cardiac cycle..
Given its rare occurrence, it's very difficult to be picked up on angio as most patients have impending cardiac rupture and eventually die in the next few minutes as the condition is mostly untreatable. Some cases of winking sign with ventricular septal rupture can be picked up as it gives more time for surgical repair as compared to free wall rupture.
In our case who was an elderly patient with inferior wall myocardial infarction who had sudden cardiac death due to cardiac rupture immediately after the angiography procedure before we could even think of an angioplasty. Winking sign is usually seen in the Artery involved in infarction because the site of cardiac rupture is usually close to the site of infarction but in this case, it was unusual that winking sign was seen in LAD while the patient was having an infarction if right coronary artery.
I too have seen this sign in angiography for the first time although it has been discussed in our cardiologists Whatsapp forum on a few occasions.
Article by:-
Dr. Navin Agrawal
Cardialogist, 21st Century Hospitals
