title: [Subacute anterior myocardial infarction after mild blunt chest trauma in a 32-year-old man].
abstract: METHODS
  A 32-year-old man came to the surgical department because of persisting retrosternal pain radiating to the left side of the thorax for two days. During a move an armchair had slipped out of his hands and caused a mild blunt chest trauma. The further clinical examination findings were unremarkable.
  
  
  METHODS
  Echocardiography was performed to rule out myocardial contusion. It showed a slightly reduced left-ventricular ejection fraction (EF 52 %) with akinesia of all apical segments overlapping to the septal and anterolateral wall, reaching the mid-ventricular area. The electrocardiogram (ECG) revealed a complete loss of R voltage of the anterior wall with persisting ST elevations in V4-V6.  Coronary angiography showed a short-length thrombotic occlusion of the left anterior descending artery (LAD) immediately after giving off the diagonal branch, based on a plaque-rupture.
  
  
  METHODS
  Because of the subacute myocardial infarction in combination with a bifurcation problem a drug-eluting stent was inserted in accordance with current studies. Initial cardiac MRT showed slightly reduced left-ventricular ejection fraction (EF 50 %), while myocardial wall thickness was preserved in all segments. Four weeks later severe myocardial remodeling had caused transmural scar formation of the anterior wall which had resulted in a reduction of left-ventricular EF to 39 %.
  
  
  CONCLUSIONS
  Myocardial infarction based on plaque-rupture can occur after a mild blunt chest trauma even in young patients. An early cardiological examination, at least an ECG, should be performed to avoid complications of mild, painful blunt chest trauma.
authors.affiliation: Klinik für Kardiologie, St. Vincenz Krankenhaus Essen, Akademisches Lehrkrankenhaus der Uni Duisburg-Essen.
authors.forename: A
authors.initials: A
authors.lastname: Halboos
authors.forename: R
authors.initials: R
authors.lastname: Jacksch
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D056988:Anterior Wall Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008297:Male; D015607:Stents; D013898:Thoracic Injuries / Q000150:complications*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology; D014949:Wounds, Nonpenetrating / Q000150:complications*