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Published on: May 28, 2019
Coronary stenting during burn shock: diagnostic and treatment considerations
Shea C Gregg1, Philip E Fidler, Nabil A Atweh
1Andrew J. Panettieri Burn Center, Department of Surgery, Section of Trauma, Burns and Surgical Critical Care, Bridgeport Hospital, Yale-New Haven Health, Bridgeport, Connecticut 06610, USA.
Abstract:
Myocardial injury is known to occur in victims of both thermal and electrical burns. A variety of mechanisms have been ascribed to the pathogenesis of cardiac damage during burn shock. However, limited evidence exists that coronary artery thrombosis plays a frequent role. Distinguishing between acute coronary syndrome (impending myocardial infarction from coronary artery occlusion) vs global cardiac injury is essential; the care diverges drastically. The following case describes a patient who was angiographically proven to have acute coronary thrombosis amidst burn shock ftera 50% TBSA electrical flash burn. Managing the patient's burn shock, myocardial injury, and multiple surgical procedures while considering antiplatelet medications for a newly placed coronary artery stent presented a number of challenges not previously reported.
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