Acute Myocardial Infarction Caused by Coronary Artery Dissection Following Blunt Chest Trauma.
10.3349/ymj.2003.44.4.736
- Author:
Se Jung YOON
1
;
Hyuck Moon KWON
;
Dong Soo KIM
;
Bum Kee HONG
;
Dong Yeon KIM
;
Yun Hyeong CHO
;
Byung Seung KANG
;
Hyun Seung KIM
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, Korea. hmkwon@yumc.yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
Trauma;
myocardial infarction;
coronary artery dissection
- MeSH:
Aged;
Aneurysm, Dissecting/diagnosis/*etiology;
Coronary Aneurysm/diagnosis/*etiology;
Coronary Angiography;
Human;
Male;
Myocardial Infarction/diagnosis/*etiology;
Radiography, Thoracic;
Thoracic Injuries/*complications;
Ultrasonography, Interventional;
Wounds, Nonpenetrating/*complications
- From:Yonsei Medical Journal
2003;44(4):736-739
- CountryRepublic of Korea
- Language:English
-
Abstract:
Chest trauma can lead to various cardiac complications ranging from simple arrhythmias to myocardial rupture. An acute myocardial infarction (AMI) is a rare complication that can occur after chest trauma. We report a case of 66-year-old male who suffered a blunt chest trauma from a traffic accident resulting in an AMI. The coronary angiography revealed an eccentric 50% narrowing of the ostium of left anterior descending artery (LAD) by a dissection flap with calcification. Intravascular ultrasonography (IVUS) revealed eccentric calcified plaque (minimal luminal diameter [MLD]=3.5 mm) with a dissection flap. Intervention was not performed considering the MLD and calcified flap, and he has been conservatively managed with aspirin and losartan for 2 years. The follow-up coronary angiography showed an insignificant luminal narrowing of the proximal LAD from the ostium without evidence of a dissection. An early coronary evaluation including an IVUS study should be considered for managing patients who complain of ongoing, deep-seated chest pain with elevated cardiac enzyme levels and an abnormal electrocardiogram (ECG) after a blunt chest trauma. Based on this case, some limited cases of traumatic coronary artery dissections can be healed with conservative management and result in a good prognosis.
