Obstruction of aortocoronary bypass due to blunt chest trauma

Prior blunt chest trauma may be a cause of single vessel coronary disease; hypothesis and review

“…One got a blow from a fist directly in the chest [43], the circumstances in the other cases are not described [40,47]. In three cases the patient got hurt from animal kicks, two from horses [52,54] and one from a cow [25]; one of these patients was kicked in the back and developed an inferior infarction.…”

“…In 31 of these patients the rest of the coronary tree was found to be normal [2,4 -7,13 -16,18-21,23,26,31 -33,37, 38,42 -44,48,51,55], six had atherosclerotic changes in the other vessels [28,30,40,41,59] and in seven patients the rest of the coronary tree was not described [10,17,29,35,46,60]. In 12 patients a dissection was found causing a stenosis but not a total occlusion [1,9,11,15,20,24,34,39,50,53,54].…”

“…Less than 24 h [11,13,19,20,29,34,44,55,59] 9 (12.9%) One day to one week [4,7,13,14,16,20,33,38,40,49,60] 13 (18.6%)…”

Coronary atherosclerotic plaque rupture following thoracic trauma – an uncommon cause of angina and ventricular tachycardia (“torsade de pointes”)

“…Blunt thoracic trauma has been previously described as a rare and often missed cause of acute myocardial infarction,1 cardiac rupture, ventricular aneurysms,2 aortocoronary bypass occlusion,3 coronary aneurysms,4 angina,5 and arrhythmias 6…”