DÄ internationalArchive12/2018A 21-Year-Old Man With Coronary Artery Dissection After Blunt Trauma to the Chest

Clinical Snapshot

A 21-Year-Old Man With Coronary Artery Dissection After Blunt Trauma to the Chest

Dtsch Arztebl Int 2018; 115: 209. DOI: 10.3238/arztebl.2018.0209

Bösche, L I; Schildhauer, T A; Hamsen, U

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Initial ECG, intra vascular ultra - sonography, and coronary angiography showing the acute proximal LAD dissection before PCI
Initial ECG, intra vascular ultra - sonography, and coronary angiography showing the acute proximal LAD dissection before PCI
Figure
Initial ECG, intra vascular ultra - sonography, and coronary angiography showing the acute proximal LAD dissection before PCI

A 21-year-old man was taken to the trauma room after a motorcycle accident. He was awake and oriented and complained of chest pain. He had no prior illnesses and no cardiovascular risk factors. The physical examination, FAST sonography, and polytrauma computed tomography revealed rib fractures and pulmonary contusions. The ECG aroused suspicion of cardiac ischemia, and a cardiologist was urgently called to the emergency room. Coronary angiography was performed at once and demonstrated a traumatic proximal LAD dissection. The lesion was then directly stented under IVUS (intravascular ultrasonographic) guidance. Six days after the accident, the patient was discharged home with only mild impairment of left-ventricular pump function revealed by echocardiography. Acute coronary artery injuries after blunt trauma to the chest are rare and life-threatening. This case underscores the need for 12-channel electrocardiography, rapid clinical response, and interdisciplinary management in the trauma emergency room.

Dr. med. Leif Ilja Bösche, Kardiologie und Angiologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil

Prof. Dr. med. Thomas Armin Schildhauer, Dr. med. Uwe Hamsen, Chirurgische Klinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum,
uwe.hamsen@bergmannsheil.de

Conflict of interest statement: The authors state that no conflict of interest exists.

Translated from the original German by Ethan Taub, M.D.

Cite this as: Bösche LI, Schildhauer TA, Hamsen U: A 21-year-old man with coronary artery dissection after blunt trauma to the chest. Dtsch Arztebl Int 2018; 115: 209. DOI: 10.3238/arztebl.2018.0209

Initial ECG, intra vascular ultra - sonography, and coronary angiography showing the acute proximal LAD dissection before PCI
Initial ECG, intra vascular ultra - sonography, and coronary angiography showing the acute proximal LAD dissection before PCI
Figure
Initial ECG, intra vascular ultra - sonography, and coronary angiography showing the acute proximal LAD dissection before PCI