Myocardial infarction following fluorescein angiography: a case report and review of the literature
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By
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Maram El-Geneidy
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Akhila Alapati
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Radwan S. Ajlan
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May 18, 2026
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Clinical Scorecard: Non-ST-Elevation Myocardial Infarction Following Fluorescein Angiography: A Case Study and Literature Review
At a Glance
| Category | Detail |
|---|
| Condition | Non-ST-Elevation Myocardial Infarction (NSTEMI) |
| Key Mechanisms | Possible allergic-mediated coronary vasospasm or anxiety-related catecholamine release. |
| Target Population | Patients undergoing fluorescein angiography, particularly those with pre-existing cardiovascular conditions. |
| Care Setting | Ophthalmology clinic and emergency department. |
Key Highlights
- Rare complication of NSTEMI following fluorescein angiography.
- Patient presented with acute chest pain shortly after the procedure.
- Cardiac catheterization confirmed right coronary artery occlusion.
- Management included dual antiplatelet therapy and beta-blockers.
- Importance of clinical vigilance and patient counseling emphasized.
Guideline-Based Recommendations
Diagnosis
- Monitor for chest pain and EKG changes post-procedure.
- Evaluate troponin levels in patients with acute chest pain.
Management
- Initiate dual antiplatelet therapy in NSTEMI cases.
- Consider cardiac catheterization for confirmed occlusions.
Monitoring & Follow-up
- Regularly assess vital signs and cardiac biomarkers after fluorescein angiography.
Risks
- Severe adverse reactions, including NSTEMI, occur in less than 1% of cases.
Patient & Prescribing Data
Elderly patients with cardiovascular risk factors.
Post-NSTEMI management included aspirin, clopidogrel, metoprolol, and ezetimibe.
Clinical Best Practices
- Ensure thorough patient history and risk assessment prior to fluorescein angiography.
- Prepare for potential acute emergencies during and after the procedure.
- Educate patients on symptoms of serious adverse reactions.
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