Coronary stenting during burn shock: diagnostic and treatment considerations.
Myocardial injury is known to occur in victims of both thermal and electrical burns. A variety of mechanisms have been ascribed to the pathogenesis of cardiac damage during burn shock. However, limited evidence exists that coronary artery thrombosis plays a frequent role. Distinguishing between acute coronary syndrome (impending myocardial infarction from coronary artery occlusion) vs global cardiac injury is essential; the care diverges drastically. The following case describes a patient who was angiographically proven to have acute coronary thrombosis amidst burn shock ftera 50% TBSA electrical flash burn. Managing the patient's burn shock, myocardial injury, and multiple surgical procedures while considering antiplatelet medications for a newly placed coronary artery stent presented a number of challenges not previously reported.
Gregg
Shea C
SC
Andrew J. Panettieri Burn Center, Department of Surgery, Section of Trauma, Burns and Surgical Critical Care, Bridgeport Hospital, Yale-New Haven Health, Bridgeport, Connecticut 06610, USA.
Fidler
Philip E
PE
Atweh
Nabil A
NA
D015906:Angioplasty, Balloon, Coronary; D002058:Burns, Electric / Q000150:complications* / Q000628:therapy; D006328:Cardiac Catheterization; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000628:therapy; D004562:Electrocardiography; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D012769:Shock / Q000150:complications* / Q000628:therapy; D015607:Stents; D013616:Tachycardia, Sinus / Q000175:diagnosis / Q000209:etiology / Q000628:therapy