Traumatic coronary artery dissection: an unusual cause of cardiac arrest

A well mid-30s man suffered a ventricular fibrillation arrest following blunt chest trauma while playing football. Development of anterior Q waves on ECG, troponin elevation >50 000 ng/L, recurrent non-sustained ventricular arrhythmias and transthoracic echocardiogram showing regional wall motion abnormality prompted diagnostic angiography. Intravascular ultrasound identified a proximally occluded LAD and dissection flap with associated haematoma, suggestive of traumatic dissection. Management included a drug-eluting stent, dual antiplatelet therapy and guideline-directed heart failure therapy. Recognition of traumatic coronary artery dissection as a differential in patients experiencing chest trauma is important to prevent diagnostic delay, which may result in poor and potentially fatal outcomes.