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Albriek AZ, Alamri S, Hamad F, Alshamiri M. Coronary artery intramural hematoma causing myocardial infarction mimicking pseudoaneurysm or dissection from trauma: A case report. Clin Case Rep 2024; 12:e8988. [PMID: 38939554 PMCID: PMC11208282 DOI: 10.1002/ccr3.8988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 06/29/2024] Open
Abstract
Blunt chest trauma caused ST-segment elevation myocardial infarction. Diagnosis of intramural hematoma (IMH) using computed tomography was confirmed using electrocardiography, cardiac marker tests, and subsequent coronary angiography. After conservative treatment, the hematoma was completely resolved 1 year later. Differentiating IMH from other arterial injuries is critical for appropriate management.
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Affiliation(s)
- Abdulilah Z. Albriek
- Department of Medical Imaging, Cardiothoracic Imaging SectionKing Saud Medical CityRiyadhSaudi Arabia
| | - Saad Alamri
- Cardiothoracic Imaging sectionSecurity Force HospitalRiyadhSaudi Arabia
| | - Faisal Hamad
- Department of Medical Imaging, Cardiothoracic Imaging SectionKing Saud Medical CityRiyadhSaudi Arabia
| | - Mostafa Alshamiri
- Department of Cardiac SciencesCollege of Medicine, King Saud UniversityRiyadhSaudi Arabia
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2
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Raffali MAAF, Azmi MI, Muhammad SF, Che Hassan HH. Delayed acute myocardial infarction in a young man with traumatic multivessel coronary artery dissection after blunt chest injury. BMJ Case Rep 2024; 17:e260649. [PMID: 38684352 PMCID: PMC11146351 DOI: 10.1136/bcr-2024-260649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/02/2024] Open
Abstract
A man in his 20s with no medical illness sustained a blunt chest injury with pneumothorax and lung contusion after involving in a motorbike accident. Five days postadmission, he subsequently had myocardial infarction with cardiac arrest, in which coronary angiogram and intravascular ultrasound showed diffused multivessel coronary artery dissection.
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Affiliation(s)
- Mohd Asyiq Al-Fard Raffali
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Malaysia
| | - Mohd Imree Azmi
- Department of Radiology, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandr Tun Razak, Malaysia
| | - Syawal Faizal Muhammad
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Malaysia
| | - Hamat Hamdi Che Hassan
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Malaysia
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3
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Son SA, Lee SC, Lee E, Lee JH. Traumatic coronary artery dissection misdiagnosed as stress-induced cardiomyopathy in a patient with multiple trauma. Trauma Case Rep 2022; 42:100698. [PMID: 36247881 PMCID: PMC9554819 DOI: 10.1016/j.tcr.2022.100698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Traumatic coronary artery dissection resulting from blunt trauma, is a relatively rare and life-threatening event. We present a case report of a 42-year-old male who presented with electrocardiogram abnormality and cardiac enzyme elevation following a fall from a height of 3 m. The patient was misdiagnosed with stress-induced cardiomyopathy because of the absence of clinical signs of acute coronary syndrome. The patient was subsequently diagnosed with traumatic coronary artery dissection using coronary angiography, and the relevance of the trauma was confirmed using intravascular ultrasonography (IVUS). Herein, we highlight that trauma team should maintain a high suspicion of traumatic coronary artery dissection, although the early recognition of traumatic coronary artery dissection can be difficult. Additionally, the importance of coronary angiography with IVUS modalities for the evaluation of traumatic coronary artery dissection is highlighted.
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Affiliation(s)
- Shin-Ah Son
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, Republic of Korea
| | - Sang Cjeol Lee
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, Republic of Korea
| | - Eunkyu Lee
- Department of Internal Medicine, CHA University, CHA Gumi Medical Center, Gumi, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, Republic of Korea,Corresponding author at: Department of Internal Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Republic of Korea.
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Bayraktaroğlu S, Nawaz Nasery M, Foladi N. Traumatic left main coronary artery dissection in a young adult following blunt chest trauma – A case report. Radiol Case Rep 2022; 17:1190-1193. [PMID: 35169426 PMCID: PMC8829528 DOI: 10.1016/j.radcr.2022.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
Blunt chest trauma may cause variable degrees of thoracic injuries. Most of the patients may remain asymptomatic after sustaining blunt chest trauma. But in rare instances, life-threatening conditions such as coronary artery dissection may occur. The authors present a 29-year-old male adult with persistent chest pain following blunt trauma with a rise in cardiac troponins and elevated ST segment in ECG. Coronary CT and conventional angiography demonstrated dissection of the left main coronary artery. It is deemed necessary to suspect cardiac injury in patients with a history of blunt chest trauma in appropriate clinical settings. Early recognition of coronary artery dissection is vital to reduce morbidity and mortality. ECG combined with cardiac enzymes can be essential tools helping the physicians raise the suspicion towards a cardiac injury followed by cross-sectional and conventional angiographies for confirmation.
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Affiliation(s)
- Selen Bayraktaroğlu
- Department of Radiology, Thoracic imaging, Ege University Hospital, Faculty of Medicine, Izmir, Turkey
| | | | - Naqibullah Foladi
- Radiology department, Wyagal Radiology Center, Kabul, Afghanistan
- Corresponding author.
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Latif RK, Clifford SP, Ghafghazi S, Phipps Z, Chen JJ, Sangroula D, Khan AZ, Saleem J, Farah I, Huang J, Businger JR. Echocardiography and Management for Cardiac Trauma. J Cardiothorac Vasc Anesth 2022; 36:3265-3277. [DOI: 10.1053/j.jvca.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/19/2022] [Accepted: 02/08/2022] [Indexed: 12/14/2022]
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Blevins AJ, Repas SJ, Alexander BM, Siebenburgen C. Blunt traumatic coronary artery dissection: A case study. Trauma Case Rep 2022; 37:100594. [PMID: 35028357 PMCID: PMC8739455 DOI: 10.1016/j.tcr.2021.100594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2021] [Indexed: 11/28/2022] Open
Abstract
Background Coronary artery dissection is an extremely rare but lethal complication of blunt chest trauma. Dissection may cause thrombus formation or vasospasm, leading to the clinical presentation of acute myocardial infarction. Diagnosis can be difficult as traumatic chest pain has several etiologies; therefore, an electrocardiogram (ECG) is necessary in all cases of thoracic trauma [1-3]. Case report Thirty-eight-year old female, with no significant past medical history, presented to a freestanding emergency department with complaints of severe chest pain and right shoulder pain after a blunt trauma water sport accident. Upon selective angiography of left and right coronary artery and left heart catheterization, the patient was found to have an occluded distal left anterior descending artery (LAD). The patient underwent aspiration thrombectomy of the proximal LAD artery and percutaneous transluminal coronary angioplasty (PTCA) of distal LAD artery, which decreased the stenosis from 100% to less than 10%. The patient was discharged home on hospital day three with follow up in one month.Coronary artery dissection should be considered in blunt thoracic trauma particularly in cases of unexplained chest pain, regardless of the mechanism of injury, age of patient or comorbidities. Patients should be evaluated with an ECG, troponin, and possibly an echocardiogram to rule out this type of injury.
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Affiliation(s)
- Aaron J Blevins
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Fairborn, OH 45324, USA
| | - Steven J Repas
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Fairborn, OH 45324, USA
| | - Brittney M Alexander
- Acute Care, Trauma, and General Surgery, Kettering Medical Center, 3535 Southern Blvd, Dayton, OH 45429, USA
| | - Christa Siebenburgen
- Acute Care, Trauma, and General Surgery, Kettering Medical Center, 3535 Southern Blvd, Dayton, OH 45429, USA
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Traumatic mitral annular avulsion and interventricular septum dissection. Cardiol Young 2021; 31:1034-1035. [PMID: 33706840 DOI: 10.1017/s1047951121000044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We presented a rare case of traumatic mitral annular avulsion and interventricular septum dissection after an unintentional falling injury in a 5-year-old female child. A successful surgical repair of mitral annulus and interventricular septum was performed to restore the haemodynamic stability.
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Kumar S, Bansal YS, Mehta N, Nada R, Girdhar P, Vishwajeet V. Blunt-chest-trauma-induced acute myocardial infarction. AUTOPSY AND CASE REPORTS 2021; 11:e2021263. [PMID: 34249785 PMCID: PMC8214881 DOI: 10.4322/acr.2021.263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/15/2021] [Indexed: 01/24/2023] Open
Abstract
Blunt chest trauma (BCT) is one of the rarest causes of acute myocardial infarction (AMI). This paper reports the case of a young married man who suffered from AMI due to BCT sustained in a fight with his wife. The histopathology examination revealed a rupture of atherosclerotic plaque with superimposed thrombus in the proximal left anterior descending artery. This report also reviews previously reported BCT-induced AMI cases in the literature.
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Affiliation(s)
- Senthil Kumar
- Postgraduate Institute of Medical Education and Research, Department of Forensic Medicine, Chandigarh, India
| | - Yogender Singh Bansal
- Postgraduate Institute of Medical Education and Research, Department of Forensic Medicine, Chandigarh, India
| | - Nikhil Mehta
- Postgraduate Institute of Medical Education and Research, Department of Forensic Medicine, Chandigarh, India
| | - Ritambhra Nada
- Postgraduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
| | - Pulkit Girdhar
- Postgraduate Institute of Medical Education and Research, Department of Forensic Medicine, Chandigarh, India
| | - Vikarn Vishwajeet
- All India Institute of Medical Sciences, Department of Pathology and Laboratory Medicine, Jodhpur, India
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Rojas ER, Gimple LW, Morsy M, Villines TC. Early Recanalization of a Traumatic Coronary Artery Dissection With Medical Therapy Alone. JACC Case Rep 2020; 2:2299-2303. [PMID: 34317159 PMCID: PMC8304569 DOI: 10.1016/j.jaccas.2020.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/24/2020] [Indexed: 10/31/2022]
Abstract
We describe a patient who presents with chest discomfort 30 h after having an accident with an all-terrain vehicle. His follow-up coronary computed tomography angiogram revealed early recanalization of his coronary artery with conservative medical therapy. (Level of Difficulty: Intermediate.)
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Pandey Y, Owen B, Birnbaum G, Tabbaa R, Hamzeh I, Lakkis N, Kayani W. Multivessel Traumatic Coronary Artery Dissection After a Motor Vehicle Accident With Successful Percutaneous Coronary Intervention. JACC Case Rep 2020; 2:2295-2298. [PMID: 34317158 PMCID: PMC8304532 DOI: 10.1016/j.jaccas.2020.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/08/2020] [Accepted: 09/18/2020] [Indexed: 11/20/2022]
Abstract
Coronary artery dissection is a rare complication of blunt chest wall trauma. We report a case of acute left anterior descending and right coronary artery dissections after a motor vehicle accident. The musculoskeletal injuries obscured the cardiac symptoms. Electrocardiogram and bedside echocardiogram revealed cardiac pathology, which prompted urgent coronary angiography and intervention. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Yagya Pandey
- Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas, USA
| | - Brittany Owen
- Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas, USA
| | - Gilad Birnbaum
- Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas, USA
| | - Rashed Tabbaa
- Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas, USA
| | - Ihab Hamzeh
- Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas, USA
| | - Nasser Lakkis
- Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas, USA
| | - Waleed Kayani
- Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas, USA
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Vyas V, Badrinath M, Szombathy T. Traumatic Right Coronary Artery Dissection as a Cause of Inferior Wall ST-Elevation Myocardial Infarction. Cureus 2020; 12:e6694. [PMID: 32104630 PMCID: PMC7026880 DOI: 10.7759/cureus.6694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Blunt cardiac injury, causing coronary artery dissection in the absence of other forms of injury to the heart or lungs is a rare occurrence. Here we present a case of a 41-year-old male who presented with right coronary artery (RCA) dissection after blunt chest trauma. The patient initially presented with chest pain and was diagnosed with an inferior wall myocardial infarction (MI). He then developed a complete heart block and bedside echocardiogram showed right ventricular akinesis. Immediate coronary angiography showed RCA dissection, and TIMI 3 flow was established after the placement of four drug-eluting stents. Blunt trauma-induced RCA dissection is associated with high mortality which needs immediate treatment. Hence through this case report, we would like to stress the importance of having a high index of suspicion for this condition in patients with a blunt chest injury.
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Affiliation(s)
- Vrinda Vyas
- Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA
| | - Madhuri Badrinath
- Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA
| | - Tamas Szombathy
- Cardiology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA
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12
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Donovan AE, Bridwell RE, Carius B, Kot C, Oliver JJ. Traumatic coronary artery dissection leading to ventricular tachycardia. Am J Emerg Med 2019; 37:1007.e5-1007.e7. [PMID: 30819580 DOI: 10.1016/j.ajem.2019.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022] Open
Abstract
Traumatic coronary artery dissection is an unusual injury following trauma. It is potentially life threatening and requires prompt recognition on presentation. We present a case report of a 42-year-old male who presented with ventricular tachycardia following a high-speed motorcycle collision that was found to have a coronary artery dissection. The patient had multiple complications, highlighting the importance of early recognition of this disease process.
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Affiliation(s)
- Andrew E Donovan
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.
| | - Rachel E Bridwell
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
| | - Brandon Carius
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
| | - Chloe Kot
- Carlisle High School, 623 W Penn Street, Carlisle, PA 17013, United States
| | - Joshua J Oliver
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
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