title: Fatal delayed cardiac tamponade due to rupture of micropseudoaneurysm of left anterior descending coronary artery following stab to the chest.
abstract: Traumatic coronary pseudoaneurysm has been described to be mainly associated to iatrogenic lesion of the coronary arteries. However, chest-stab-wound-related coronary pseudoaneurysm caused by isolated partial incision of a coronary artery giving rise to fatal delayed cardiac tamponade is very rare. We describe an autopsy case in which this potentially fatal complication developed 8 days later after a thoracic stab wound. Unfortunately, the imaging examination failed to detect this defect during hospitalization. Postmortem examination revealed that the posterior wall of the left anterior descending coronary artery was intact but that the anterior wall was incised, forming a micropseudoaneurysm which had ruptured. This case highlights that isolated coronary artery injuries must be considered in any patient with a penetrating wound to the thorax, and coronary pseudoaneurysms should not be missed in these patients.
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, PR China.
authors.forename: Jingjun
authors.initials: J
authors.lastname: Xing
authors.affiliation: Department of Public Security of Hubei Province, NO.181 Xiongchu Avenue, Wuhan, 430070, RP China.
authors.forename: Shangxun
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, PR China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, PR China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, PR China.
authors.forename: Yijie
authors.initials: Y
authors.lastname: Duan
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, PR China.
authors.forename: Wenhe
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, PR China. Electronic address: zhouyiwu@outlook.com.
authors.forename: Yiwu
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D017541:Aneurysm, False / Q000209:etiology* / Q000473:pathology; D017542:Aneurysm, Ruptured / Q000209:etiology* / Q000473:pathology; D001344:Autopsy; D002305:Cardiac Tamponade / Q000209:etiology* / Q000473:pathology; D002423:Cause of Death; D003323:Coronary Aneurysm / Q000209:etiology* / Q000473:pathology; D003331:Coronary Vessels / Q000293:injuries* / Q000473:pathology; D003951:Diagnostic Errors; D017809:Fatal Outcome; D006335:Heart Injuries / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D013997:Time Factors; D057772:Vascular System Injuries / Q000209:etiology* / Q000473:pathology; D014951:Wounds, Stab / Q000209:etiology* / Q000473:pathology
keywords: Chest stab wound; Coronary pseudoaneurysm; Delayed cardiac tamponade; Isolated coronary artery injury