Acute Myocardial Infarction Caused by Coronary Artery Dissection after a Blunt Chest Trauma

Lin, Ying‐Li; Yu, Chao-Hung

doi:10.2169/internalmedicine.50.5688

Cited by 17 publications

(7 citation statements)

References 3 publications

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“…Tetapi jika perdarahannya masif pada organ serebral, limpha, hepar, dan mediastinum tidak disarankan untuk melakukan tindakan PCI (Fu, Z. L., & Yao, H. C., 2013). Pernyataan ini diperkuat oleh Lin, Y., & Yu, C. (2011), menemukan kasus IMA akibat trauma tumpul thorax disertai dengan trauma serebral yang mendapatkan tindakan PCI. Setelah tindakan emergensi dengan PCI terjadi perdarahan intrakranial kemudian pasien dilakukan tindakan craniotomi dan pasien KRS pada hari ke-50 setelah menjalani rehabilitasi di RS.…”

Section: Pembahasanunclassified

Literature Review : Percutaneus Coronary Intervention Sebagai Tindakan Emergensi Pada Kasus Infark Miokard Akut Akibat Trauma Tumpul Thorax

Sari

Rianto²

2020

CMSNJ

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Latar belakang: Infark miokard akut (IMA) penyebab non aterosklerotik pada dewasa muda disebabkan oleh trauma tumpul thorak merupakan kasus yang langka, tetapi berpotensi mengancam nyawa yang harus ditangani segera pada pasien yang datang ke IGD. Percutaneus Coronary Intervention (PCI) adalah standar emas untuk diagnosis dan manajemen. Karena prognosis pasien ini terkait erat dengan diagnosis dan penatalaksanaan dini, sangat penting untuk menjaga indeks kecurigaan yang tinggi untuk Acute Coronary Syndrome (ACS) pada pasien dengan trauma tumpul thorax dan nyeri dada. Tujuan: penelitian ini bertujuan untuk menyajikan tindakan PCI pada pasien IMA disebabkan oleh trauma tumpul thorax dan untuk meninjau beberapa litelatur mengenai topik ini. Metode: penelitian ini merupakan bentuk literature review terhadap artikel dengan tema Percutaneus Coronary Intervention pada pasien infark miokard akut penyebab trauma tumpul thorax. Artikel pada penelitian ini berasal dari database elektronik Google Scholar, PubMed, Proquest, Scopus dan Science Direct dimulai tahun 2005 sampai dengan 2020. Hasil: hasil penelusuran menggunakan kata kunci Percutaneus Coronary Intervention, acute myocardial infarction, blunt chest trauma diperoleh 56 artikel. 15 artikel yang memenuhi kriteria inklusi kemudian dilakukan review terhadap full text nya. Kesimpulan: Tindakan emergensi Percutaneus Coronary Intervention efektif dilakukan dan merupakan terapi yang aman untuk kasus Infark Miokard Akut akibat trauma tumpul Thorax. Tindakan emergensi Percutaneus Coronary Intervention menjadi pilihan terbaik untuk pasien tanpa disertai dengan perdarahan pada organ lain.

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Section: Pembahasanunclassified

Literature Review : Percutaneus Coronary Intervention Sebagai Tindakan Emergensi Pada Kasus Infark Miokard Akut Akibat Trauma Tumpul Thorax

Sari

Rianto²

2020

CMSNJ

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“…A retrospective study[9] revealed male dominance for commotio cordis following assaults, as male-to-female ratio of 37:2, among age group of 13–47 years. Chest blows were produced by fists (28 cases, 71.8%), feet (6 cases, 15.4%), knee (2 case, 5.1%), head (1 case, 2.6%), or objects (2 cases, 5.1%).…”

Section: Blunt Cardiac Injurymentioning

confidence: 99%

“…Chest blows were produced by fists (28 cases, 71.8%), feet (6 cases, 15.4%), knee (2 case, 5.1%), head (1 case, 2.6%), or objects (2 cases, 5.1%). [9]…”

Section: Blunt Cardiac Injurymentioning

confidence: 99%

“…Almost 2% of coronary artery injuries can be related to BCI, causing coronary artery dissection that leads to myocardial ischemia. [910] The most commonly involved artery is the left anterior descending (71.4%), followed by the right coronary artery (19%), left main (6.4%), and circumflex (3.2%). In addition to the spontaneous occurrence, the high-speed impacts and contact sports are the frequent causes of coronary artery dissection.…”

Section: Blunt Cardiac Injurymentioning

confidence: 99%

See 1 more Smart Citation

Traumatic blunt cardiac injuries: An updated narrative review

Fadel

El‐Menyar

ElKafrawy

et al. 2019

Int J Crit Illn Inj Sci

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Blunt cardiac injury (BCI) is defined as injuries sustained due to blunt trauma to the heart, and it remains unchanged for long time. The spectrum of BCI ranges from a minor “bruise” to specific postcontusion cardiac conditions such as free-wall rupture. This is a narrative review provides a continued and updates details regarding BCIs from 2008 to 2017. For this purpose, a narrative review of literature was conducted using appropriate database for retrieval of articles through systematic search methodology. Autopsy-based studies are very limited. It can be concluded that regardless of the variability in the spectrum of modalities and medical/surgical resources, BCIs diagnosis and management remain a puzzle and needs further prospective studies.

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“…16 Myocardial infarction can result if the torn portion of the intima acts as a flap that obscures blood flow within the true lumen of the coronary artery or if propagation of the dissection otherwise obliterates distal perfusion. 17,18 The ensuing ischemia will be evidenced on ECG and by elevations in cardiac troponins and should prompt immediate coronary angiography with percutaneous or surgical revascularization as appropriate. 16,19 Valve injuries, particularly papillary muscle rupture leading to acute valvular regurgitation, are another type of structural BCI seen in survivors.…”

Section: Structural Injuriesmentioning

confidence: 99%

Common Cause of Mortality in Trauma but Manageable Nonetheless

et al. 2015

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Foreword Information about a real patient is presented in stages (boldface type) to expert clinicians (Drs Eachempati and Salemi), who respond to the information, sharing their reasoning with the reader (regular type). A discussion by the authors follows.A n obese but otherwise healthy 53-year-old man was unloading a delivery van when he was struck from behind by a slow-moving garbage truck, pinning him between the 2 vehicles. The patient was lying supine on the ground when emergency medical services arrived. He was alert and oriented with a Glasgow Coma Scale score of 15. The patient was complaining of pain in his right upper extremity and numbness in his left foot. His initial vital signs were notable for a heart rate of 100 bpm; his blood pressure was 150/90 mm Hg; and his breathing was elevated at 22 breaths per minutes. The patient denied loss of consciousness and had no neck, back, or chest pain. Per emergency medical services, the patient's midchest appeared erythematous and his left lung field was coarse on auscultation, and he had a small abrasion on his left knee. The rest of his in-the-field examination was unremarkable. A cervical collar was placed, and the patient was placed on a back-board for transport. The patient's vital signs remained stable en route per the emergency medical services' report, although he became increasingly anxious and repeatedly removed both his cervical collar and a nonrebreather mask that had been placed empirically.On arrival in our trauma bay, the patient was found to be in shock: pulse rate, 129 bpm; blood pressure, 69/51 mm Hg; respiratory rate, 20 breaths per minute; and O 2 saturation, 80% on room air. He remained awake with a Glasgow Coma Scale score of 15 but now was complaining of difficulty breathing and of right-sided chest and back pain. His primary survey was notable for rhonchorous breath sounds bilaterally and right-sided chest wall crepitus; his abdomen was soft and had no peritoneal signs. The patient remained tachycardic, but his blood pressure improved to 127/113 mm Hg as 2 L crystalloid and 1 U red blood cells were given in bolus. His O 2 saturation improved to 96% on a nonrebreather mask providing O 2 at 15 L/min. His initial ECG demonstrated sinus tachycardia with questionable electric alternans in leads V 1 and V 5 (Figure 1). The patient's focused assessment with sonography for trauma (FAST) examination was unremarkable. A chest radiograph revealed extensive right subcutaneous emphysema, multiple right lateral rib fractures, a small rightsided apical pneumothorax, and bilateral patchy opacities consistent with pulmonary contusion or hemorrhage. His cardiomediastinal silhouette was normal (Figure 2A). A pelvic radiograph was negative for injury. A right chest tube was inserted with minimal serosanguinous output ( Figure 2B), and a Foley catheter was placed.Dr Eachempati: Care of traumatically injured patients demands the participation of various members of a large, interdisciplinary team and, depending on local practice, can involve surgeons, emergenc...

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Acute Myocardial Infarction Caused by Coronary Artery Dissection after a Blunt Chest Trauma

Cited by 17 publications

References 3 publications

Literature Review : Percutaneus Coronary Intervention Sebagai Tindakan Emergensi Pada Kasus Infark Miokard Akut Akibat Trauma Tumpul Thorax

Literature Review : Percutaneus Coronary Intervention Sebagai Tindakan Emergensi Pada Kasus Infark Miokard Akut Akibat Trauma Tumpul Thorax

Traumatic blunt cardiac injuries: An updated narrative review

Common Cause of Mortality in Trauma but Manageable Nonetheless

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