Acute Anterior Wall Myocardial Infarction Secondary to Blunt Chest Trauma—A Case Report

Abstract

Cardiac injuries following nonpenetrating chest trauma have been reported. These include cardiac arrhythmias, septal damage, valve damage, coronary fistula, coronary artery damage, ventricular aneurysm, cardiac rupture, and myocardial infarction. Myocardial infarction as a complication of chest trauma has been reported in very few cases. In this report the authors describe a patient who developed anterior wall myocardial infarction secondary to a blunt chest trauma.

Prior blunt chest trauma may be a cause of single vessel coronary disease; hypothesis and review

“…In 31 of these patients the rest of the coronary tree was found to be normal [2,4 -7,13 -16,18-21,23,26,31 -33,37, 38,42 -44,48,51,55], six had atherosclerotic changes in the other vessels [28,30,40,41,59] and in seven patients the rest of the coronary tree was not described [10,17,29,35,46,60]. In 12 patients a dissection was found causing a stenosis but not a total occlusion [1,9,11,15,20,24,34,39,50,53,54].…”

“…Less than 24 h [11,13,19,20,29,34,44,55,59] 9 (12.9%) One day to one week [4,7,13,14,16,20,33,38,40,49,60] 13 (18.6%)…”

Cardio-embolic stroke following remote blunt chest trauma

“…The most common mechanisms of injury include direct, bidirectional, decelerative, blast, and concussive forces. 4 The most frequently affected vessel is the LAD (71e76% of cases) followed by the right coronary (12%e19.0%) and the circumflex coronary artery (3.2e6%). The anatomic proximity of the LAD to the anterior chest wall probably makes it more vulnerable to damage from direct trauma.…”

Acute myocardial infarction following blunt chest trauma due to sea traffic accident

“…The mechanism of traumatic coronary artery damage that can result in MI after BCT includes intimal tear, dissection, subintimal hemorrhage, intraluminal thrombosis and spasms in the area of coronary artery contusion. Other probable mechanisms of thrombotic coronary injury include vessel rupture and external compression by epicardial hematoma, occlusive dissection of the artery, or hemorrhage into a pre-existing atheromatous plaque [3,5]. There could be difficulties in establishing the diagnosis of acute MI in a BCT setting.…”