Early detection of myocardial infarction following blunt chest trauma by computed tomography: a case report.
Blunt cardiac trauma encompasses a wide range of clinical entities, including myocardial contusion, cardiac rupture, valve avulsion, pericardial injuries, arrhythmia, and even myocardial infarction. Acute myocardial infarction due to coronary artery dissection after blunt chest trauma is rare and may be life threatening. Differential diagnosis of acute myocardial infarction from cardiac contusion at this setting is not easy.



Here we demonstrated a case of blunt chest trauma, with computed tomography detected myocardium enhancement defect early at emergency department. Under the impression of acute myocardial infarction, emergent coronary angiography revealed left anterior descending artery occlusion. Revascularization was performed and coronary artery dissection was found after thrombus aspiration. Finally, the patient survived after coronary stenting.



Perfusion defects of myocardium enhancement on CT after blunt chest trauma can be very helpful to suggest myocardial infarction and facilitate the decision making of emergent procedure. This valuable sign should not be missed during the initial interpretation.
Division of Cardiology, Department of Internal Medicine, E-Da hospital / I-Shou University, Kaohsiung, Taiwan.
Thung-Lip
TL
Lee
Division of Cardiology, Department of Internal Medicine, E-Da hospital / I-Shou University, Kaohsiung, Taiwan.
Chin-Feng
CF
Hsuan
Division of Cardiology, Department of Internal Medicine, E-Da hospital / I-Shou University, Kaohsiung, Taiwan.
Chen-Hsiang
CH
Shih
Division of Cardiology, Department of Internal Medicine, E-Da hospital / I-Shou University, Kaohsiung, Taiwan.
Huai-Wen
HW
Liang
Division of Cardiology, Department of Internal Medicine, E-Da hospital / I-Shou University, Kaohsiung, Taiwan.
Hsing-Shan
HS
Tsai
Division of Cardiology, Department of Internal Medicine, E-Da hospital / I-Shou University, Kaohsiung, Taiwan. arthurtseng@me.com.
Wei-Kung
WK
Tseng
Department of Internal Medicine, E-Da cancer hospital / I-Shou University, Kaohsiung, Taiwan.
Kwan-Lih
KL
Hsu
D000063:Accidents, Traffic; D000328:Adult; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000293:injuries; D042241:Early Diagnosis; D004562:Electrocardiography; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011237:Predictive Value of Tests; D015607:Stents; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000628:therapy
Blunt chest trauma; Computed tomography; Coronary dissection; Myocardial infarction