This report describes the case of a 64-year-old woman with loss of consciousness, forced deviation of the head and eyes, and signs of myocardial infarction immediately after flushing of a pleural drain. A CT scan of the brain demonstrated extensive bifrontal air configurations and her ECG showed ST-segment elevation. She was diagnosed with cerebral and coronary air embolism. She responded favourably to two sessions of hyperbaric oxygen therapy. We conclude that arterial gas embolism can develop, even in the absence of a right-to-left shunt, if air enters directly into the pulmonary veins.
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