Coronary occlusion secondary to blunt chest trauma: a first attempt at balloon angioplasty

Area of Science:

• Cardiology
• Trauma Medicine
• Interventional Cardiology

Background:

• Transmural myocardial infarction (MI) from closed-chest trauma is rare, with few documented cases.
• Percutaneous transluminal coronary angioplasty (PTCA) has not been previously reported as a treatment for this condition.

Purpose of the Study:

• To report a case of anterior-wall myocardial infarction secondary to blunt chest trauma.
• To evaluate the efficacy of PTCA in treating coronary artery occlusion following blunt chest trauma.

Main Methods:

• A 40-year-old male patient with myocardial infarction post-blunt chest trauma underwent coronary angiography.
• The patient was treated with balloon angioplasty, followed by a second attempt, and subsequently surgical revascularization.

Main Results:

• Coronary angiography revealed isolated total obstruction of the left anterior descending coronary artery two months after trauma.
• Initial PTCA resulted in total reocclusion within 24 hours; a second attempt failed to restore patency.
• Surgical revascularization performed a week later resulted in the patient remaining asymptomatic a year post-injury.

Conclusions:

• PTCA, despite its initial failure in this case, may still be considered a treatment option for young patients with single-vessel coronary artery disease resulting from blunt chest trauma.
• Surgical revascularization proved effective in restoring patency and achieving a favorable long-term outcome in this patient.