Traumatic Right Coronary Artery Dissection as a Cause of Inferior Wall ST-Elevation Myocardial Infarction
Vrinda Vyas1, Madhuri Badrinath1, Tamas Szombathy2
1Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.
Blunt chest trauma can cause rare right coronary artery dissection, leading to myocardial infarction and heart block. Prompt diagnosis and stenting are crucial for survival in this critical condition.
Area of Science:
- Cardiology
- Trauma Surgery
Background:
- Blunt cardiac injury is uncommon.
- Coronary artery dissection without other thoracic trauma is exceptionally rare.
Observation:
- A 41-year-old male sustained blunt chest trauma.
- Presented with chest pain, diagnosed with inferior wall myocardial infarction.
- Developed complete heart block and right ventricular akinesis on echocardiogram.
Findings:
- Coronary angiography revealed right coronary artery dissection.
- Successful revascularization achieved with four drug-eluting stents, restoring TIMI 3 flow.
Implications:
- Blunt trauma-induced coronary artery dissection carries high mortality.
- Emphasizes the need for high clinical suspicion in blunt chest trauma patients.
- Immediate intervention is critical for favorable outcomes.
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