Acute Myocardial Infarction in a Patient with Primary Coronary Dissection and Severe Coronary Vasospasm

Abstract

A case of myocardial infarction associated with coronary artery dissection in a thirty-five-year-old woman is reported. An emergent coronary angiogram revealed extensive dissection and thrombosis in the right coronary artery; in addition, severe vasospasm was observed in the left coronary artery on the next day. She was successfully treated with intracoronary thrombolysis and intra-aortic balloon pumping. The patient is alive and well two years after infarction.

Coronary Thrombosis without Dissection following Blunt Trauma

“…Since the advent of primary percutaneous intervention, there have been several reports of AMI due to total epicardial thrombotic occlusion following blunt trauma and its successful treatment by percutaneous intervention [ 13 – 17 ]. Proposed mechanisms for AMI in this setting have included intimal injury due to shear forces imparted by the blunt trauma [ 18 , 19 ], plaque rupture, coronary artery dissection, and coronary vasospasm [ 20 ]. In several reports, the presence of coronary artery dissection has been documented as the underlying pathophysiologic trigger for thrombosis [ 4 – 8 ].…”

Sealed with a Kick: A Case of Posttraumatic Coronary Artery Dissection and Cardiomyopathy

“…Trauma-related myocardial infarction is caused by a variety of pathologic causes including: intimal tear, plaque rupture associated thrombosis, coronary artery disease, coronary artery spasm, coronary artery dissection, and compression due to epicardial hematoma [3]. The arteries most likely to be associated with trauma are the LAD (71.4%) and the RCA (19%) [4].…”

“…The reported incidence of injury varies from to 2 to 71% [2]. Non-atherosclerotic myocardial infarction is thought to occur through intimal laceration and thrombotic process activation secondary to the impact of the trauma and through acceleration and deceleration forces [3, 4]. Here we present a case of a young patient with acute myocardial infarction and cardiomyopathy after being kicked in the chest.…”

Acute Fatal Coronary Artery Dissection Following Exercise‐related Blunt Chest Trauma

“…Coronary artery dissection is recognized as an unusual complication of blunt chest trauma . Nonpenetrating chest trauma is most commonly caused by motor vehicle accidents .…”