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[Traumatic injury to the heart. A clinical study (author's transl)]
Insights
Nonpenetrating chest trauma can cause cardiac damage, including myocardial infarction. Prompt coronary angiography is crucial for diagnosing heart attacks after chest injuries, especially in legal cases.
Area of Science:
- Cardiology
- Trauma Medicine
- Forensic Pathology
Context:
- Nonpenetrating chest injuries frequently result in cardiac trauma.
- The relationship between chest trauma severity and cardiac damage is not always correlated.
Purpose:
- To investigate the occurrence of myocardial infarction following nonpenetrating chest trauma.
- To highlight the diagnostic importance of coronary angiography in post-traumatic cardiac events.
Summary:
- Two cases presented with post-traumatic coronary thrombosis and myocardial infarction, leading to anterior aneurysms.
- A third case showed intramural infarction, possibly due to intramyocardial bleeding without coronary thrombosis, given a normal coronary angiogram.
- A direct link between chest injury and myocardial infarction is suggested if symptoms appear within 24-48 hours of trauma.
Impact:
- Emphasizes the need for coronary angiography in myocardial infarction cases following chest injury.
- Provides insights for clinical diagnosis and medico-legal evaluations in trauma-related cardiac events.
Abstract:
Nonpenetrating chest injuries often lead to cardiac traumas. Posttraumatic coronary thrombosis with myocardial infarction is shown in two cases. Large anterior aneurysm occured after total occlusion of the descending anterior in both cases. There was no correlation between the severity of the chest injury and the ensuing cardiac damage. An intramural anterior infarction was seen in a third case; because of a normal coronary angiogram an intramyocardial bleeding without coronary thrombosis can be suspected. A direct connection between chest injury and myocardial infarction can only be assumed if there is an onset of symptoms within 24--48 hours after thoracic trauma. A coronary angiogram should be performed in any case of myocardial infarction following chest injury especially in medico-legal cases.