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Blunt traumatic coronary artery dissection: A case study.
Aaron J Blevins1, Steven J Repas1, Brittney M Alexander2
1Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Fairborn, OH 45324, USA.
Trauma Case Reports
|January 14, 2022
Summary
Blunt chest trauma can cause coronary artery dissection, a rare but serious condition. Prompt diagnosis with ECG and imaging is crucial for patients experiencing chest pain after trauma.
Area of Science:
- Cardiology
- Trauma Surgery
- Emergency Medicine
Background:
- Coronary artery dissection is a rare but life-threatening complication of blunt chest trauma.
- It can mimic acute myocardial infarction due to thrombus formation or vasospasm.
- Diagnosing dissection is challenging due to various chest pain etiologies after trauma.
Observation:
- A 38-year-old female presented with severe chest and right shoulder pain post-blunt trauma.
- Selective angiography revealed an occluded distal left anterior descending artery (LAD).
- The patient had no significant past medical history.
Findings:
- Aspiration thrombectomy and percutaneous transluminal coronary angioplasty (PTCA) successfully treated the 100% LAD stenosis.
- Post-intervention, stenosis was reduced to less than 10%.
- The patient was discharged on hospital day three.
Implications:
- Coronary artery dissection must be considered in blunt thoracic trauma, irrespective of patient age or comorbidities.
- Evaluation should include ECG, troponin levels, and potentially echocardiography.
- Early recognition and intervention are vital for favorable outcomes in traumatic coronary artery dissection.
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