Acute myocardial infarction caused by coronary artery dissection following blunt chest trauma.
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.
Yoon
Se Jung
SJ
Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Kwon
Hyuck Moon
HM
Kim
Dong Soo
DS
Hong
Bum Kee
BK
Kim
Dong-Yeon
DY
Cho
Yun-Hyeong
YH
Kang
Byung Seung
BS
Kim
Hyun-Seung
HS
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*