1.A Case of Acute Myocardial Infarction after Blunt Chest Trauma in a Young Man.
Woo Seok PARK ; Myung Ho JEONG ; Young Joon HONG ; Ok Young PARK ; Joo Han KIM ; Weon KIM ; Young Keun AHN ; Jeong Gwan CHO ; Jong Chun PARK ; Byoung Hee AHN ; Sang Hyung KIM ; Jung Chae KANG
Journal of Korean Medical Science 2003;18(6):889-893
Coronary artery injury rarely occurs after blunt chest trauma, but it can lead to extensive myocardial infarction and be frequently overlooked. A 16-yr-old man was presented with comatose mental state and rapid respiration rate. He ran into guard rail while riding a motorcycle. In routine examination, his electrocardiogram showed Q wave and 2 mm ST segment elevation in all precordial leads, I and aVL. The cardiac enzymes were also elevated: creatine kinase (CK)-MB was 300 U/L, and cardiac specific troponin I was 5.7 ng/mL. Two-dimensional echocardiography showed anteroseptal akinesia with severely depressed left ventricular function, ejection fraction of 28%. He could not receive any anticoagulation or thrombolytic therapy because of his brain lesion. Three weeks later, his mental state improved. A diagnostic coronary angiogram revealed total occlusion in the proximal left anterior descending artery (LAD) with collaterals from the right coronary artery and left circumflex artery. We successfully performed a percutaneous coronary intervention for the LAD lesion, and the final angiogram showed a good coronary flow without residual stenosis.
Adolescent
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Angioplasty, Transluminal, Percutaneous Coronary
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Brain/pathology
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Coronary Angiography
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Echocardiography
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Electrocardiography
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Human
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Male
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Myocardial Infarction/*etiology/therapy
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Thoracic Injuries/*complications/pathology/ultrasonography
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Tomography, X-Ray Computed
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Ventricular Dysfunction, Left