Left anterior descending coronary artery dissection after blunt chest trauma.
Coronary artery dissection is a well-known albeit unusual complication of blunt chest trauma. It is also an uncommon cause of myocardial infarction. Only a few such cases have been reported, probably due to the high rate of sudden death. We report a case of left anterior descending (LAD) coronary artery dissection in a healthy 38-year-old female caused by blunt chest trauma. The patient was referred to our hospital with a complaint of chest pain. Electrocardiography showed T-wave inversion, echocardiography a revealed circumferential pericardial effusion, and the coronary angiogram demonstrated a thrombotic dissection of the LAD.  Troponin I was the only biomarker with elevated level. CT coronary angiography was performed using the subtotal occlusion of the LAD and illustrated a relatively good LAD run-off, and thallium scintigraphy displayed viable myocardium in this territory. Despite the total occlusion of the LAD in our case, myocardial injury was not significant due to the relatively good LAD run-off. She underwent coronary artery bypass graft surgery with an excellent result.
Cardiac Electrophysiology Research Center, Rajaie Cardiovascular, Medical and Research Centre, Tehran University of Medical Sciences, Tehran, Iran. monami_58@yahoo.co.uk.
Mohammad Ali
MA
Sadr-Ameli
Rajaie Cardiovascular, Medical and Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
Elaheh
E
Amiri
Radiology department, Rajaie Cardiovascular, Medical and Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
Hamidreza
H
Pouraliakbar
Cardiac Electrophysiology Research Center, Rajaie Cardiovascular, Medical and Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
Mona
M
Heidarali
D000063:Accidents, Traffic; D000328:Adult; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000293:injuries* / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D006335:Heart Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology; D010490:Pericardial Effusion / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating