Coroner's Finding: Richardson, Margaret Rita

67y · Female·right coronary artery dissection following angiography stenting and attempted rotational atherectomy due to occluded right coronary artery by ischaemic heart disease

Margaret Richardson, 67, died from right coronary artery dissection during rotational atherectomy for treatment of occluded coronary artery. She had presented with ST elevation myocardial infarction and underwent initial successful angiography with stenting. During subsequent rotational atherectomy to address a calcified lesion, coronary artery perforation occurred. Although the perforation was stented and initially appeared sealed, she developed profound hypotension, pericardial effusion, and cardiac arrest. Despite resuscitation and intensive care with inotropic support, she died. The coroner found that rotational atherectomy was the most appropriate treatment option, the complication was a recognised risk, and all reasonable care and proper salvage steps were employed. No preventability findings or recommendations were made.