Metallic taste after coronary artery stent implantation

Abstract

Percutaneous coronary intervention (PCI) with stent implantation has become the first choice of treatment for acute myocardial infarction [1]. The most often used metals and metallic alloys for manufacturing stents have a net positive electrical charge on their surface [2]. Dental procedures that use amalgam are the most frequent restoration techniques worldwide. In contrast with the alloys used for stent manufacturing, most alloys used in dental fillings tend to be electronegative. Oral galvanic currents and the elucidated metallic vapor release have long been recognized as a potential source of oral discomfort [3]. The phenomenon of oral galvanism results from the difference in electrical potential between dissimilar restorative metals located in the mouth. Whether electrical potential difference between coronary stents and metals located in the mouth has any clinical implication is uncertain. A 54-year-old male, with 2-hour chest pain and ST elevation in anterior ECG leads has been admitted to our invasive cardiology center for primary percutaneous coronary intervention (PCI). A diagnosis of anterior ST-elevation myocardial infarction (STEMI) was made and the subsequent coronary angiography described an occlusion of a left anterior descendent coronary artery. A successful revascularization was performed with implantation of an endothelial progenitor cell capture 3.0×23 mm stent (Genous Bio-engineered R stentTM, OrbusNeich Medical Technologies, Fort Lauderdale, FL, USA). Three days after the PCI, the patient was discharged without symptoms. One month after the PCI a progressive severe disturbance in sense of taste with metallic taste and inability to distinguish between