Coronary Thrombosis without Dissection following Blunt Trauma

Abstract

Blunt trauma to the chest resulting in coronary thrombosis and ST elevation myocardial infarction (STEMI) is a rare but well-described occurrence in adults. Angiography in such cases has generally disclosed complete epicardial coronary occlusion with thrombus, indistinguishable from the findings commonly found in spontaneous plaque rupture due to atherosclerotic disease. In all previously reported cases in which coronary interrogation with intravascular ultrasound (IVUS) was performed in association with acute revascularization, coronary artery dissection was implicated as the etiology of coronary thrombosis. We present the first case report of blunt trauma-associated coronary thrombosis without underlying atherosclerosis or coronary dissection, as documented by IVUS imaging.

Tension Pneumomediastinum and Coronary Artery Thrombosis Following a Motorcycle Accident: A Case Report

“…Isolated CAT following BCT in the absence of concurrent coronary artery dissection is a rare complication that has been reported sparingly in the literature; therefore, its epidemiology is difficult to define. 4 As with coronary artery dissection, there is predilection for the left anterior descending artery, which is hypothesized to be due to its anatomically vulnerable location immediately behind the sternum. 11 The pathophysiology of thrombus formation is hypothesized to involve endothelial injury to the coronary artery wall caused by direct blunt trauma as well as indirect kinetic energy transmission that causes further damage or stasis of flow.…”

“…Blunt chest trauma causing CAT in the absence of coronary artery dissection has been sparsely reported in the literature. 4 Herein, we report a unique case of a 40-year-old man who presented with pneumothorax, pneumomediastinum, and CAT following a motorcycle accident.…”

Right Coronary Artery STEMI following Blunt Thoracic Trauma

“…However, this does occur with a proposed etiology due to the superficial anatomic location of the coronaries making the vessels susceptible to thrombosis formation in the setting of a traumatic event [4,5]. Furthermore, since the left anterior descending artery is the most anterior vessel and hence in the most vulnerable position, it is also the most commonly injured [4,[6][7][8][9][10][11][12][13]. This case report of AMI with occlusion of the pRCA, rPL, and PDA represents an exceedingly rare complication of blunt thoracic trauma.…”

Delayed left traumatic diaphragmatic hernia mimicking acute coronary syndrome

“…A variety of cardiovascular pathologies have been associated with blunt trauma injury, including myocardial contusion, aortic transection or less often aortic dissection, traumainduced ventricular arrhythmia or commotio cordis in young children, hemopericardium with tamponade, and aortic valve leaflet avulsion. AMI is a rare but well-described complication of Traumatic diaphragmatic hernias blunt trauma to the chest [11]. In the literature review, most of the cases of acute coronary artery occlusion are associated with a blunt chest injury and pre-existing atherosclerotic coronary artery disease have been described [12].…”