Coronary Arterial Laceration after Blunt Chest Trauma

Suzuki, Ichirô; Sato, M.; Hoshi, Naoto; Nanjo, Hiroshi

doi:10.1056/nejm200009073431017

Cited by 12 publications

(10 citation statements)

References 4 publications

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“…Rupture or laceration of a coronary artery can result in bleeding into the pericardial or pleural cavities. Aside from laceration caused by a broken rib [ 6 , 7 ], the mechanism by which a coronary artery ruptures is not well understood. Shearing forces from craniocaudal deceleration, and compression of the chest while the patient is holding his breath (compression-Valsalva injury) have been implicated as possible mechanisms [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…RBB on ECG. RCA Tricuspid valve Present N/A b ACB 8 h Survived Suzuki et al 2000 [ 6 ]. 59 M FD Autopsy Severe dyspnea and chest pain 14 h after the incident.…”

Section: Discussionmentioning

confidence: 99%

“…CXR may show fractured ribs but coronary artery rupture may occur with an intact thoracic skeleton [ 12 ]. The heart shadow may appear enlarged due to hemopericardium, but a traumatic communication between the pericardial and pleural cavities can result in the appearance of pleural effusion in its place [ 6 , 7 ]. Similarly, pericardial effusion, which is the principal manifestation of coronary artery rupture, can be undetectable or absent on FAST exam if the pericardium is not intact.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanical energy from trauma transmitted to coronaries can result in intimal tears, wall dissection, dislodgement or rupture of a pre-existing atherosclerotic plaque, coronary artery spasm, or coronary artery rupture [ 1 , 3 – 5 ]. Fractured ribs from blunt trauma can result in coronary laceration [ 6 , 7 ]. Lesions that result in subsequent occlusion of the involved coronary artery (like intimal tears, wall dissection, rupture of a pre-existing atheromatous plaque, and coronary artery spasm) can culminate in myocardial infarction, which can be immediate or delayed [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Coronary artery rupture in blunt thoracic trauma: a case report and review of literature

Abuhmeidan

Arrowaili

Yousef

et al. 2016

J Cardiothorac Surg

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BackgroundBlunt thoracic trauma can rarely result in coronary artery injury. Blunt trauma can result in occlusion of any of the coronary arteries or can lead to its rupture and bleeding. Traumatic coronary artery occlusion can lead to myocardial infarction, while its rupture and bleeding can result in hemopericardium and cardiac tamponade, and can be rapidly fatal. Survival after coronary artery rupture in blunt thoracic trauma is exceedingly rare.Case PresentationWe present a case of a young male who sustained a blunt thoracic trauma in a motor vehicle collision, that resulted in rupture of the left anterior descending (LAD) coronary artery and subsequent cardiac tamponade. Prompt surgical intervention with pericardiotomy and ligation of the artery has resulted in survival of the patient.ConclusionsIn cases of traumatic coronary artery rupture, early surgical intervention is crucial to avoid mortality. Ligation of the injured coronary is a viable option in selected cases, and can be the most expeditious option in patients in extremis.

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Section: Discussionmentioning

confidence: 99%

“…RBB on ECG. RCA Tricuspid valve Present N/A b ACB 8 h Survived Suzuki et al 2000 [ 6 ]. 59 M FD Autopsy Severe dyspnea and chest pain 14 h after the incident.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Coronary artery rupture in blunt thoracic trauma: a case report and review of literature

Abuhmeidan

Arrowaili

Yousef

et al. 2016

J Cardiothorac Surg

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“…Note the left pneumothorax and the laceration of the lingula (arrowhead), a finding that suggests the course of the stab wound with a trajectory directed lateral from the mediastinum. myocardial defects, blood can leak from the cardiac injury through the pericardial defect without accumulating in the pericardial space (21,22), with the result that a cardiac injury might not be suspected at US or CT. In addition, pericardial fat may appear sonolucent at US, thereby mimicking hemopericardium (23).…”

Section: Cardiac Injurymentioning

confidence: 99%

Current Concepts in Imaging Evaluation of Penetrating Transmediastinal Injury

Gunn¹,

Clark²,

Sadro³

et al. 2014

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Penetrating transmediastinal injuries (TMIs) are injuries that traverse the mediastinum. These injuries are most commonly caused by firearms and knives. The investigation and management algorithms for TMI have undergone changes in recent years due to increasing evidence that computed tomography (CT) in useful in the evaluation of hemodynamically stable TMI patients. Initial investigation of TMI patients depends on the question of hemodynamic stability. In unstable patients, imaging (if any) should be limited to bedside radiography and focused ultrasonography. In hemodynamically stable patients in whom a mediastinal trajectory of injury is suspected, the primary imaging modality after radiography should be multidetector CT. CT is invaluable in the assessment of TMI due to its capacity to depict the injury track as well as demonstrate both direct and indirect signs of organ injury. On the basis of the suspected trajectory and specific findings, radiologists can play an essential role in determining future patient management and investigations for each mediastinal organ, thereby expediting appropriate investigation and treatment and avoiding unnecessary and sometimes invasive tests or surgery. The authors provide an up-to-date and evidence-based approach for the management of hemodynamically unstable and stable patients with suspected TMI, discuss management algorithms and CT protocols, and highlight common and uncommon imaging findings and diagnostic pitfalls associated with vascular, cardiac, esophageal, tracheobronchial, pleural, and pulmonary injuries. Online supplemental material is available for this article.

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Blunt Trauma

2007

Forensic Pathology of Trauma

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Coronary Arterial Laceration after Blunt Chest Trauma

Cited by 12 publications

References 4 publications

Coronary artery rupture in blunt thoracic trauma: a case report and review of literature

Coronary artery rupture in blunt thoracic trauma: a case report and review of literature

Current Concepts in Imaging Evaluation of Penetrating Transmediastinal Injury

Blunt Trauma

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