Left anterior descending artery dissection: a rare sequela of blunt chest trauma

Abstract

Traumatic coronary artery (CA) dissection is an extremely rare sequela of blunt chest trauma. Diagnosis of CA dissection in the setting of chest trauma is challenging. While conventionally coronary angiography has been the diagnostic tool of choice, modern imaging techniques such as optical coherence tomography can further improve diagnostic accuracy and help optimise treatment strategy. The ideal treatment modality for managing CA dissection has not been established with case reports revealing a range of treatment strategies ranging from CA bypass grafting to a completely conservative management. Here we present a case report of a 68‐year‐old man who suffered a traumatic proximal left anterior descending artery dissection as a consequence of a motor‐vehicle accident and was subsequently treated with a combination of conservative and interventional strategy with optimal patient outcome.

Blast Injury

“…Serial ECG follow-up and regional wall abnormalities on the echocardiogram can be helpful in most cases. Previous studies have reported blunt chest trauma as the cause of coronary artery dissection ( 9 , 10 ). Coronary artery dissection can sometimes lead to ST-segment elevation myocardial infarction.…”

Blunt traumatic right coronary artery dissection presenting with second-degree atrioventricular block and late-onset severe cardiogenic shock

“…The diagnosis of CA dissection in the setting of chest trauma is challenging. While conventionally coronary angiography has been the diagnostic tool of choice [ 4 , 5 ], modern imaging techniques such as computed tomography coronary angiography (CTCA) can further improve diagnostic accuracy and help optimize the treatment strategy [ 6 ]. This fast and non-invasive diagnostic method provides good quantitative and qualitative assessment of the coronary arteries and the aortic root.…”

“…The ideal treatment modality for managing CA dissection has not been established yet, with case reports revealing a variety of treatment strategies [ 6 ]. Possible options include invasive techniques (percutaneous transluminal coronary angioplasty), surgical revascularization, thrombolysis (at the risk of deterioration of the dissection) and conservative treatment.…”