An Uncommon Cause of ST-Segment Elevation Myocardial Infarction

Abstract

Intramural coronary hematoma (IMCH) is a rare cause of acute myocardial infarction (MI). We aim to review the current knowledge and share our experience with the diagnosis and management of a patient presenting with traumatic IMCH leading to an acute ST-segment elevation MI. ( Level of Difficulty: Intermediate. )

Coronary artery intramural hematoma causing myocardial infarction mimicking pseudoaneurysm or dissection from trauma: A case report

“…IMH after trauma is an extremely rare and fatal phenomenon. Based on our literature review, only four case reports have described IMH of the LAD in patients 1–3,6 . Traumatic IMH may result from blunt trauma to the chest caused by, for example, motor vehicle accidents or direct blows to the chest during contact sports 3 .…”

“…[1][2][3]6 Traumatic IMH may result from blunt trauma to the chest caused by, for example, motor vehicle accidents or direct blows to the chest during contact sports. 3 The proposed mechanisms of injury include compression of the coronary artery between the heart and chest wall, rapid deceleration forces, and direct laceration of the artery. 7,8 Acute ST-elevation myocardial infarction is a very rare complication of blunt chest trauma.…”

“…Coronary angiography, along with coronary computed tomography (CT), can be used to locate and characterize the nature of coronary artery injuries on admission and during follow‐up. 1 , 2 , 3 …”

“…Blunt trauma to the chest is associated with potentially high mortality and can cause injury to the heart, lungs, and coronary vessels, including dissection, contusion, and intramural hematoma (IMH). Coronary angiography, along with coronary computed tomography (CT), can be used to locate and characterize the nature of coronary artery injuries on admission and during follow‐up 1–3 …”

“…Coronary angiography, along with coronary computed tomography (CT), can be used to locate and characterize the nature of coronary artery injuries on admission and during follow-up. [1][2][3] IMH of the coronary artery and other coronary artery injuries resulting from trauma are extremely rare, potentially life-threatening, and can lead to myocardial infarction. IMH is characterized by the accumulation of blood within the arterial wall due to rupture of the vasa vasorum.…”