Right Coronary Artery Fistula and Occlusion Causing Myocardial Infarction after Blunt Chest Trauma

Kim, Kun Il; Lee, Won Yong; Ko, Ho Hyun; Kim, Hyoung Soo; Lee, Hee Sung

doi:10.5090/kjtcs.2014.47.4.402

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Multiple mechanisms exist leading to coronary artery dissection, including intimal tears due to a deceleration injury, compression of the artery between the heart and sternum, coronary spasm, and impairment of the coronary flow by a dissection flap or a superimposed thrombosis [ 3 ]. Coronary artery dissection is detected most commonly in the LAD (76%), the right coronary artery (12%), and the circumflex artery (6%) [ 4 , 5 ]. In necropsy series, the most common cause of acquired non-atherosclerotic coronary artery disease is spontaneous coronary artery dissection, and the LAD is the artery in which this condition is most commonly detected [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back

İpek

Ermis

Demirelli

et al. 2015

Korean J Thorac Cardiovasc Surg

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We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.

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Section: Discussionmentioning

confidence: 99%

Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back

İpek

Ermis

Demirelli

et al. 2015

Korean J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

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Fast resolution of mild midvetricular takotsubo syndrome triggered by blunt chest trauma: case study

Elikowski,

Szczęśniewski,

Fertała

et al. 2024

Polski Merkuriusz Lekarski

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Blunt chest trauma (BCT) may rarely trigger stress-induced takotsubo syndrome (TTS) which requires dif f erential diagnosis with myocardial contusion and BCT-induced myocardial infarction. So far reported cases have been presented as apical ballooning or inverted (reverse) TTS forms but not as a midventricular variant. The authors described a case of a 53-year-old female admitted to Intensive Care Unit after motor vehicle accident with BCT and airbag deployment during car roll over. For some time after the accident, she was trapped in a car with her head bent to the chest. After being pulled out from the car, she had impaired consciousness and therefore was intubated by the rescue team. Trauma computed tomography scan did not reveal any injuries. However, ECG showed ST-segment depression in II, III, aVF, V4-6, and discrete ST-segment elevation in aVR. Troponin I and NTpro-BNP increased to 2062 ng/l and 6413 pg/ml, respectively. Echocardiography revealed mild midventricular dysfunction of the left ventricle with ejection fraction (EF) and global longitudinal strain (GLS) reduced to 45% and -17.6%, respectively. On day two, the patient’s general condition improved and stabilized, so she was extubated. Normalization of ECG, EF and GLS (but not regional LS) was observed on day three. She was discharged home on day fi ve. Post-hospital examinations documented that segmental longitudinal strain remained abnormal for up to 4 weeks. The authors conclude that fast ECG and echocardiographic evolution may result in underestimation of the posttraumatic TTS diagnosis, especially if it takes atypical form and its course is mild. Longitudinal strain evaluation can be helpful in cardiac monitoring of trauma patients.

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Right Coronary Artery Fistula and Occlusion Causing Myocardial Infarction after Blunt Chest Trauma

Cited by 2 publications

References 8 publications

Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back

Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back

Fast resolution of mild midvetricular takotsubo syndrome triggered by blunt chest trauma: case study

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