Catheter-Induced Left Ventricular Perforation and Cardiac Tamponade During Left Heart Catheterization.

Iatrogenic ventricular perforation of the myocardial wall is a rare but life-threatening complication. It has been described using pulmonary artery catheter, pigtail catheter, and Judkins catheter. Straight wires and catheters can be used to cross the aortic valve for left ventriculogram; however, the risk of perforation is higher compared with J-tip wires. Prompt recognition of cardiac tamponade and pericardial drain insertion is vital, but surgical patch repair may be required for definitive treatment. This case highlights the importance of increased vigilance and prompt management of cardiac tamponade with the use of high-risk equipment during cardiac catheterization.