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Blunt cardiac injury presenting as a left-sided coronary artery dissection

Alex Park1, Daniel R Principe1

  • 1Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.

Journal of Surgical Case Reports
|February 16, 2022
PubMed

Insights

Blunt cardiac injuries (BCIs) can rarely affect coronary arteries, presenting atypically. This case highlights BCIs manifesting in left-sided coronary artery dissection following thoracic trauma.

Area of Science:

  • Cardiology
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Blunt cardiac injuries (BCIs) classically involve right-sided heart chambers.
  • Coronary artery involvement in BCIs is exceptionally rare.
  • Diagnosis of traumatic coronary dissection is complicated by variable presentations and co-occurring injuries.

Observation:

  • A patient with blunt thoracic trauma from an automobile accident presented with diffuse ST-segment elevations on ECG.
  • Coronary angiography revealed left anterior descending artery occlusion and obtuse marginal artery stenosis.
  • The patient was diagnosed with a BCI causing left-sided coronary artery dissection.

Findings:

  • Blunt cardiac injuries can manifest in any cardiac anatomy, not just the classically affected right-sided chambers.
  • Coronary artery dissection is a rare but possible consequence of blunt thoracic trauma.
  • ECG changes like diffuse ST-segment elevation can indicate coronary injury in trauma patients.

Implications:

  • Clinicians should consider BCIs in patients with thoracic trauma, even with atypical presentations.
  • Early diagnosis and management of traumatic coronary artery dissection are crucial.
  • This case broadens the understanding of potential BCI manifestations and diagnostic considerations.

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