Traumatic Coronary Artery Dissection with Secondary Acute Myocardial Infarction after Blunt Thoracic Trauma

Area of Science:

• Cardiology
• Trauma Surgery
• Radiology

Background:

• Traumatic injuries can affect cardiovascular structures.
• High-speed motor vehicle collisions pose significant risks for severe trauma.

Observation:

• A 41-year-old male sustained severe injuries, including intracranial hemorrhages and rib fractures, from a motor vehicle collision.
• Initial computed tomography (CT) scans revealed multiple traumatic injuries but the coronary artery dissection was only noted retrospectively.
• The patient presented with an acute myocardial infarction, confirmed by electrocardiogram.

Findings:

• Emergency coronary angiography demonstrated a complete dissection of the right coronary artery.
• Despite stent placement, there was no reflow in the affected artery.
• The patient expired the following day due to complications.

Implications:

• Traumatic coronary artery dissection is a rare but fatal complication of severe blunt chest trauma.
• Radiologists and clinicians should maintain a high index of suspicion for coronary artery injury in patients with severe trauma, even if not immediately apparent.
• Early recognition and management of traumatic coronary artery dissection may improve patient outcomes, though it remains challenging.