title: A case of acute myocardial infarction after blunt chest trauma in a young man.
abstract: Coronary artery injury rarely occurs after blunt chest trauma, but it can lead to extensive myocardial infarction and be frequently overlooked. A 16-yr-old man was presented with comatose mental state and rapid respiration rate. He ran into guard rail while riding a motorcycle. In routine examination, his electrocardiogram showed Q wave and 2 mm ST segment elevation in all precordial leads, I and aVL. The cardiac enzymes were also elevated: creatine kinase (CK)-MB was 300 U/L, and cardiac specific troponin I was 5.7 ng/mL. Two-dimensional echocardiography showed anteroseptal akinesia with severely depressed left ventricular function, ejection fraction of 28%. He could not receive any anticoagulation or thrombolytic therapy because of his brain lesion. Three weeks later, his mental state improved. A diagnostic coronary angiogram revealed total occlusion in the proximal left anterior descending artery (LAD) with collaterals from the right coronary artery and left circumflex artery. We successfully performed a percutaneous coronary intervention for the LAD lesion, and the final angiogram showed a good coronary flow without residual stenosis.
authors.affiliation: The Heart Center of Chonnam National University Hospital, The Chonnam National University Research Institute of Medical Science, Gwangju, Korea.
authors.forename: Woo Seok
authors.initials: WS
authors.lastname: Park
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Ok Young
authors.initials: OY
authors.lastname: Park
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Byoung Hee
authors.initials: BH
authors.lastname: Ahn
authors.forename: Sang Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Jung Chae
authors.initials: JC
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D015906:Angioplasty, Balloon, Coronary; D001921:Brain / Q000473:pathology; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology* / Q000628:therapy; D013898:Thoracic Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left