ST-Elevation Myocardial Infarction after Penetrating Thoracic Trauma
Kiran Faryar1, Michael P Flaherty2, Martin Huecker1
1Department of Emergency Medicine, University of Louisville, Louisville, Kentucky.
The Journal of Emergency Medicine
|March 21, 2017
Summary
ST-segment elevation myocardial infarction (STEMI) can occur after chest trauma. This case highlights that conservative management may be suitable for stable patients without coronary artery issues.
Area of Science:
- Emergency Medicine
- Cardiology
- Trauma Surgery
Background:
- Penetrating thoracic trauma can lead to ST-segment elevation myocardial infarction (STEMI).
- Prompt recognition and evaluation are crucial for appropriate patient management.
Observation:
- A case report of a 42-year-old male with a self-inflicted gunshot wound to the chest presented with STEMI.
- Initial management involved conservative treatment due to hemodynamic stability.
- Subsequent cardiac catheterization revealed no coronary artery atherosclerosis or traumatic injury.
Findings:
- STEMI occurred in the absence of detectable plaque rupture or direct coronary trauma.
- This presentation is unusual and challenges typical STEMI etiologies.
Implications:
- The decision for emergent coronary angiography in trauma-related STEMI should be individualized based on hemodynamic status and cardiac risk factors.
- Conservative medical management is a viable option for asymptomatic, hemodynamically stable patients.
- Myocardial infarction should be considered in the initial assessment of penetrating thoracic injuries.
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