A case of acute myocardial infarction after blunt chest trauma in a young man.
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.
Park
Woo Seok
WS
The Heart Center of Chonnam National University Hospital, The Chonnam National University Research Institute of Medical Science, Gwangju, Korea.
Jeong
Myung Ho
MH
Hong
Young Joon
YJ
Park
Ok Young
OY
Kim
Joo Han
JH
Kim
Weon
W
Ahn
Young Keun
YK
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Ahn
Byoung Hee
BH
Kim
Sang Hyung
SH
Kang
Jung Chae
JC
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