A Rare Case of ST-elevation Myocardial Infarction After Blunt Chest Trauma

Very low risk of ST-elevation and non-ST-elevation myocardial infarction in patients with chest trauma

BACKGROUND

The goal of this study was to evaluate any association between blunt chest trauma and occurrence of ST-elevation myocardial infarction and non-ST-elevation myocardial infarction.

METHODS

Data from the National Inpatient Sample (NIS) database from 2010-2014, of patients over the age of 40, hospitalized for blunt chest trauma (ICD 959.11), with STEMI or NSTEMI, was used in this study. We performed a chi-squared test to analyze this association. We also performed a multivariant analysis adjusting for race, gender, and age.

RESULTS

We found that there is not an increased risk of STEMI/NSTEMI following blunt chest trauma, P > 0.05. We also found no correlation between STEMI or NSTEMI and chest trauma after adjusting for race, gender, and age. For STEMI after adjustments in 2010 (P=0.52), 2011 (P=0.19), 2012 (P=0.60), 2013 (P=0.88), and 2014 (P=0.14). For NSTEMI adjustments in 2010 (P=0.03), 2011 (P=0.06), 2012 (P=0.01), 2013 (P=0.21), and 2014 (P=0.03).

CONCLUSION

Both ST-elevation myocardial infarction and non-ST-elevation myocardial infarction were not significantly associated with blunt chest trauma.

Blunt Chest Trauma Causing a Displaced Sternal Fracture and ST-elevation Myocardial Infarction: A Case Report

INTRODUCTION

Blunt chest trauma and motor vehicle collisions are common presentations to the emergency department (ED). Chest pain in a trauma patient can usually and reasonably be attributed to chest wall injury, leading to a potential delay in diagnosis and treatment.

CASE REPORT

In this case report, we present a 52-year-old male who was brought to the ED with complaints of chest pain and pressure after a motor vehicle collision. He was subsequently found to have both a displaced sternal fracture and simultaneous acute myocardial infarction with 100% occlusion of the mid left anterior descending artery without dissection requiring stent placement.

CONCLUSION

Chest pain after blunt cardiac trauma is a common complaint. While rare, acute myocardial infarction must be considered. Most injuries result as direct trauma to the artery causing either dissection or acute thrombosis resulting in a myocardial infarction as opposed to acute plaque rupture with thrombosis, as seen in this case.