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Traumatic coronary artery dissection: a case report and literature review

Kevin W Lobay1, Cameron K MacGougan

  • 1Department of Emergency Medicine, University of Alberta, Royal Alexandra Hospital, Edmonton, Alberta, Canada.

The Journal of Emergency Medicine
|July 8, 2010
PubMed

Insights

Blunt chest trauma can cause rare coronary artery dissection. Prompt recognition and interventions like stenting improve patient outcomes in this critical condition.

Area of Science:

  • Cardiology
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Coronary artery dissection (CAD) following blunt chest trauma is a rare but critical medical emergency.
  • This condition can lead to rapid clinical deterioration and requires immediate attention.

Observation:

  • A 50-year-old female sustained traumatic coronary artery dissection after a high-speed motor vehicle collision.
  • She presented with ST-segment elevation on electrocardiogram, hypoxemic respiratory failure, and hypotension, necessitating intubation and inotropic support.
  • Computed tomography revealed pulmonary edema and rib fractures, while emergent angiography confirmed left main coronary artery dissection requiring stent placement.

Findings:

  • Early electrocardiogram screening is crucial for identifying traumatic coronary artery dissection.
  • Aggressive management, including angiography with stent placement, coronary artery bypass grafting, or conservative strategies, can lead to favorable outcomes.

Implications:

  • This case highlights the importance of considering coronary artery dissection in patients with blunt chest trauma and concerning cardiac symptoms.
  • Timely diagnosis and appropriate intervention are vital for improving survival rates in traumatic coronary artery dissection.
Abstract

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