Yonsei Med J.  2003 Aug;44(4):736-739. 10.3349/ymj.2003.44.4.736.

Acute Myocardial Infarction Caused by Coronary Artery Dissection Following Blunt Chest Trauma

• Yoon SJ
• Kwon HM
• Kim DS
• Hong BK
• Kim DY
• Cho YH
• Kang BS
• Kim HS

• KMID: 720919
• DOI: http://doi.org/10.3349/ymj.2003.44.4.736

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.

Keyword

Trauma; myocardial infarction; coronary artery dissection

MeSH Terms

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