Paradoxical air embolism to left anterior descending artery during induction of anesthesia in a patient with an atrial septal defect.

Systemic air embolism is a complication after IV injection of air bubbles adhering to IV tubing, 3-way injection ports, and residual air in drug-filled syringes. Paradoxical air embolism across an intracardiac septal defect is a well-known complication, but paradoxical air embolism to the left coronary artery is a rare condition. We report the case of a 50-year-old woman scheduled for elective device closure of an atrial septal defect in whom coronary air embolism to the left anterior descending artery occurred after anesthetic induction.