Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back.
10.5090/kjtcs.2015.48.4.281
- Author:
Emrah IPEK
1
;
Emrah ERMIS
;
Selami DEMIRELLI
;
Erkan YILDIRIM
;
Mustafa YOLCU
;
Bingul Dilekci SAHIN
Author Information
1. Department of Cardiology, Erzurum Region Training and Research Hospital, Turkey. dremrah21@yahoo.com
- Publication Type:Case Report
- Keywords:
Coronary;
Back;
Dissection;
Kick;
Traumatic
- MeSH:
Accelerated Idioventricular Rhythm;
Adult;
Ambulatory Care Facilities;
Arteries;
Back Pain;
Blood Pressure;
Cardiopulmonary Resuscitation;
Coronary Angiography;
Coronary Vessels*;
Dopamine;
Fatigue;
Female;
Follow-Up Studies;
Heart Arrest;
Humans;
Hypotension;
Intensive Care Units;
Norepinephrine;
Operating Rooms;
Oxygenators, Membrane;
Pallor;
Saphenous Vein;
Shock, Cardiogenic;
Spouses;
Transplants
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2015;48(4):281-284
- CountryRepublic of Korea
- Language:English
-
Abstract:
We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.
