Acute myocardial infarction due to left anterior descending coronary artery dissection after blunt chest trauma.
Cardiac complications of chest trauma range from arrhythmias to valvular avulsions to myocardial contusion, rupture, and rarely myocardial infarction. We describe a case of a young patient with blunt chest trauma after a motor vehicle accident in whom the diagnosis of myocardial infarction was established a week later because no electrocardiogram or cardiac biomarkers were obtained on presentation. Retrospective review of contrast-enhanced computed tomography (CT) of the chest done on presentation demonstrated a perfusion defect in the distribution of the left anterior descending artery (LAD). Subsequent coronary angiography demonstrated dissection in the proximal LAD. Our case illustrates the importance of electrocardiography and contrast-enhanced chest CT in initial evaluation of patients with blunt chest trauma and suspected injury to the coronary arteries.
Oghlakian
Gerard
G
Department of Medicine, New Jersey Medical School, Newark, NJ, USA. drgerhald@hotmail.com
Maldjian
Pierre
P
Kaluski
Edo
E
Saric
Muhamed
M
D000063:Accidents, Traffic; D000328:Adult; D003287:Contrast Media; D004452:Echocardiography / Q000379:methods; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D013898:Thoracic Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging
D003287:Contrast Media