Left anterior descending coronary artery dissection after blunt chest trauma

Arch Iran Med. 2014 Jan;17(1):86-90.

Abstract

Coronary artery dissection is a well-known albeit unusual complication of blunt chest trauma. It is also an uncommon cause of myocardial infarction. Only a few such cases have been reported, probably due to the high rate of sudden death. We report a case of left anterior descending (LAD) coronary artery dissection in a healthy 38-year-old female caused by blunt chest trauma. The patient was referred to our hospital with a complaint of chest pain. Electrocardiography showed T-wave inversion, echocardiography a revealed circumferential pericardial effusion, and the coronary angiogram demonstrated a thrombotic dissection of the LAD. Troponin I was the only biomarker with elevated level. CT coronary angiography was performed using the subtotal occlusion of the LAD and illustrated a relatively good LAD run-off, and thallium scintigraphy displayed viable myocardium in this territory. Despite the total occlusion of the LAD in our case, myocardial injury was not significant due to the relatively good LAD run-off. She underwent coronary artery bypass graft surgery with an excellent result.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic*
  • Adult
  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Vessels / injuries*
  • Coronary Vessels / surgery
  • Electrocardiography
  • Female
  • Heart Injuries / complications
  • Heart Injuries / diagnostic imaging*
  • Heart Injuries / surgery
  • Humans
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / etiology
  • Pericardial Effusion / etiology
  • Tomography, X-Ray Computed
  • Wounds, Nonpenetrating*