Post Traumatic Pseudoaneurysm of Left Anterior Descending Artery Presenting as Acute Coronary Syndrome
Saptarshi Biswas1, Boris Hristov2, Sudhakar Kinthala3
1Department of Trauma, Acute Care Surgery and Surgical Critical Care, Forbes Hospital, Allegheny Health Network, Monroeville, PA, USA.
Insights
Penetrating cardiac injuries can cause delayed complications. A rare case of left anterior descending pseudoaneurysm and stenosis, presenting as acute coronary syndrome months after trauma, was successfully treated with stenting.
Area of Science:
- Cardiology
- Trauma Surgery
- Interventional Cardiology
Background:
- Penetrating cardiac injuries have high mortality and can lead to delayed sequelae.
- Documented complications include myocardial infarction, aneurysms, and valvular dysfunction.
Observation:
- A unique case of a patient with a left anterior descending (LAD) pseudoaneurysm and stenosis is presented.
- This condition arose months after an initial penetrating cardiac injury.
Findings:
- The patient presented with acute coronary syndrome (ACS).
- The LAD pseudoaneurysm and stenosis were successfully managed with stenting.
Implications:
- Coronary artery pseudoaneurysms are rare but serious delayed complications of penetrating chest trauma.
- Stenting offers a viable treatment option for LAD pseudoaneurysm and stenosis presenting as ACS.
Abstract:
Penetrating cardiac injuries are highly lethal and carry high mortality rate. Both blunt and penetrating cardiac injuries in patients who survive are known to present with well-known sequelae that often appear days to weeks after the initial insult. In the literature there have been documented cases of cardiac injury induced myocardial infarction, ventricular aneurysms, valvular dysfunction and even fistulous tracts between the coronary vessels and chamber. Although the most commonly injured vessel is the left anterior descending (LAD) coronary artery, traumatic injuries to the left coronary artery result in early death in the majority of cases. We present a unique case of LAD pseudo aneurysm and stenosis presenting as acute coronary syndrome (ACS) months after the initial penetrating cardiac injury successfully managed by stenting. There are only few isolated case reports of coronary artery pseudoaneurysm following penetrating chest trauma published in English literature.
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