Treatment Approach of Acute Coronary Thrombosis without Dissection in a Bleeding Patient with Multiple Trauma

Trauma is one of the causes of acute myocardial infarction (AMI). In the literature, coronary dissection or vasospasm is thought to play a role in the aetiology of AMI, but the presence of coronary thrombosis without coronary dissection is uncommon. If bleeding pathologies occur in addition to traumatic coronary thrombosis, this may make the situation more complicated. A 32-year male patient was brought to a tertiary emergency service due to a car accident. We detected femoral shaft fracture, hemothorax, subdural haemorrhage, and coronary thrombosis without dissection in the patient. A chest tube was inserted and emergency coronary angiography was performed. Total occlusion of the left anterior descending artery (LAD) was detected. Balloon angioplasty was done and a stent was applied to the LAD. Acetyl salicylic acid and clopidogrel were started despite his bleeding pathologies. In trauma patients, coronary thrombosis without coronary dissection may occur with bleeding pathologies. Electrocardiography should be performed in patients with chest trauma. Thrombosis-bleeding balance should be carefully evaluated during treatment and treatment should be determined by taking this situation into consideration. Key Words: Coronary thrombosis, Multiple trauma, Bleeding, Angioplasty, Antiplatelet therapy.