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Multivessel Traumatic Coronary Artery Dissection After a Motor Vehicle Accident With Successful Percutaneous Coronary

Yagya Pandey1, Brittany Owen1, Gilad Birnbaum1

  • 1Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas, USA.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Blunt chest trauma can cause rare coronary artery dissections, specifically affecting the left anterior descending and right coronary arteries. Prompt diagnosis via ECG and echocardiogram is crucial for timely intervention.

Area of Science:

  • Cardiology
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Coronary artery dissection is an uncommon yet serious complication following blunt chest wall trauma.
  • Motor vehicle accidents are a significant cause of blunt chest trauma.

Observation:

  • A case is presented involving acute left anterior descending and right coronary artery dissections after a motor vehicle accident.
  • Musculoskeletal injuries associated with the trauma masked the initial cardiac symptoms.
  • Initial diagnostic tools included electrocardiogram and bedside echocardiogram.

Findings:

  • Electrocardiogram and echocardiogram successfully identified underlying cardiac pathology.
  • Urgent coronary angiography was performed, leading to necessary intervention.
  • The patient experienced dissections in both the left anterior descending and right coronary arteries.

Implications:

  • This case highlights the importance of considering coronary artery dissection in patients with blunt chest trauma, even when musculoskeletal injuries are prominent.
  • Early recognition and diagnostic imaging are vital for prompt treatment and improved patient outcomes.
  • Highlights the need for a high index of suspicion for cardiac injury in trauma patients.

Keywords:
CT, computed tomographyECG, electrocardiogramLAD, left anterior descending coronary arteryRCA, right coronary arteryTIMI, Thrombolysis In Myocardial Infarctionacute coronary syndromecoronary angiographydissection

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