Right coronary artery fistula and occlusion causing myocardial infarction after blunt chest trauma

Area of Science:

• Cardiology
• Trauma Surgery
• Medical Case Reports

Background:

• Coronary artery fistula (CAF) is an abnormal connection between a coronary artery and a cardiac chamber or vessel.
• Blunt chest trauma is an uncommon cause of coronary artery abnormalities and myocardial infarction (MI).

Observation:

• A patient presented with inferior myocardial infarction (MI) five months after blunt chest trauma.
• Initial emergency room evaluation following trauma did not diagnose acute myocardial infarction.
• The patient was diagnosed with a right coronary artery (RCA)-right atrial fistula and distal RCA occlusion as the cause of MI.

Findings:

• The patient experienced a delayed diagnosis of myocardial infarction (MI) attributed to a coronary artery fistula and occlusion.
• The underlying cause was identified as a right coronary artery (RCA)-right atrial fistula with distal RCA occlusion following blunt chest trauma.

Implications:

• This case underscores the importance of considering rare complications like coronary artery fistulas after chest trauma, even with delayed presentation.
• Early recognition and surgical intervention for traumatic coronary artery fistula and occlusion can lead to favorable outcomes.
• Highlights the diagnostic challenges and potential for delayed presentation of myocardial infarction secondary to trauma-induced coronary artery abnormalities.