title: Acute myocardial infarction caused by coronary artery dissection following blunt chest trauma.
abstract: Chest trauma can lead to various cardiac complications ranging from simple arrhythmias to myocardial rupture. An acute myocardial infarction (AMI) is a rare complication that can occur after chest trauma. We report a case of 66-year-old male who suffered a blunt chest trauma from a traffic accident resulting in an AMI. The coronary angiography revealed an eccentric 50% narrowing of the ostium of left anterior descending artery (LAD) by a dissection flap with calcification. Intravascular ultrasonography (IVUS) revealed eccentric calcified plaque (minimal luminal diameter [MLD]=3.5 mm) with a dissection flap. Intervention was not performed considering the MLD and calcified flap, and he has been conservatively managed with aspirin and losartan for 2 years. The follow-up coronary angiography showed an insignificant luminal narrowing of the proximal LAD from the ostium without evidence of a dissection. An early coronary evaluation including an IVUS study should be considered for managing patients who complain of ongoing, deep-seated chest pain with elevated cardiac enzyme levels and an abnormal electrocardiogram (ECG) after a blunt chest trauma. Based on this case, some limited cases of traumatic coronary artery dissections can be healed with conservative management and result in a good prognosis.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Se Jung
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Hyuck Moon
authors.initials: HM
authors.lastname: Kwon
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Kim
authors.forename: Bum Kee
authors.initials: BK
authors.lastname: Hong
authors.forename: Dong-Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Yun-Hyeong
authors.initials: YH
authors.lastname: Cho
authors.forename: Byung Seung
authors.initials: BS
authors.lastname: Kang
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology*; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology*; D017023:Coronary Angiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*; D013902:Radiography, Thoracic; D013898:Thoracic Injuries / Q000150:complications*; D018084:Ultrasonography, Interventional; D014949:Wounds, Nonpenetrating / Q000150:complications*