A case of development of cardiogenic shock after intra-arterial injection of papaverine during measuring of fractional flow reserve in left anterior descending artery

Myocardial infarction complicated by cardiogenic shock is a rare but severe iatrogenic complication of invasive procedures. Damage of microcirculatory vessels; microcirculatory disorder, oedema of pericapillary tissues; embolization by microcrystals of contrast agent and platelet masses; inflammatory reaction in response to histamine release, dysfunctions of the heart's autonomic nervous system cause “No-reflow” and “Slow-reflow” phenomena which leads to the development of pathological condition. In this case, a choice of interventions tactics depends on physician and is determined individually in each separate case, nevertheless the need of complete myocardial revascularization seems obvious.