Delayed diagnosis of myocardial infarction in a young man with a blunt chest trauma

Abstract

A 19 year old man was admitted to emergency department (ED) because of motorcycle to motorcycle accident. In ED he was evaluated as a multiple trauma patient and after overnight observation, was discharged with stable vital signs (VS) next morning. Twenty four hours later, he developed chest pain and dyspnea, and was admitted to ED for the second time. This time he was evaluated as a chest trauma patient and chest X ray and CT scanning were performed. According to cardiology consult, an electrocardiogram was recorded and extensive anterolateral ST elevation myocardial infarction (STEMI) was confirmed. Coronary angiography revealed total thrombotic occlusion of left anterior descending artery (LAD) from ostium. Percutaneous coronary intervention (PCI) was performed and LAD stented successfully. After 10 days of ICU admission, he was discharged with an ejection fraction (EF) of 35%.

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.…”