ST-Elevation Myocardial Infarction after Penetrating Thoracic Trauma

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Kiran Faryar1, Michael P Flaherty2, Martin Huecker1

  • 1Department of Emergency Medicine, University of Louisville, Louisville, Kentucky.

The Journal of Emergency Medicine
|March 21, 2017
PubMed

Insights

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.
Abstract

Keywords:
ST-segment elevationgunshot woundinfarctionpenetrating trauma

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