Concurrent carotid rupture and coronary dissection after blunt chest trauma

Traumatic Coronary Dissection: Case Presentation and Literature Review

In posttraumatic coronary dissection, a small intimal tear occurs due to the sudden compression of the thoracic wall during the chest trauma, this being sometimes fatal. We present the case of a 56-year-old truck driver with chest trauma after a car crash. The 12-lead ECG showed signs suggestive of an acute anterior myocardial infarction, and the coronary angiography confirmed an arterial dissection of the left anterior descending coronary artery. A stent was inserted the same day, and the patient was treated accordingly. He survived for a total of three days. The autopsy and histological examination confirmed the MI and the coronary dissection. The chest trauma was linked to the patient’s death. The literature review reveals 46 cases in which the most frequent cause of chest trauma was a car or motorcycle accident; also, young male subjects were more frequently involved. Stent placement was the main course of treatment, and a delay in the onset of symptoms was also frequent.

Coronary artery dissection and acute myocardial infarction following blunt chest trauma

Blunt chest trauma might lead to cardiac injury ranging from simple arrhythmias to lethal conditions such as cardiac rupture. We experienced a case of initially overlooked traumatic coronary artery dissection which resulted in acute myocardial infarction (AMI). A high degree of suspicion is needed to diagnose this condition. Based on our case, we will give an overview of relevant literature on this topic. ECG, echocardiography, coronary angiography and cardiac enzymes are valuable tools in diagnosing this rare condition. The time span from coronary artery occlusion to revascularisation must be short if AMI is to be avoided.