Why the study?
Coronary vasospasm is rarely reported as a consequence of blunt chest trauma, with only one prior reported case.
Coronary vasospasm should be suspected in trauma patients with unexplained hypotension, new conduction abnormalities, or ECG evidence of ischemia, and can be successfully treated with vasodilators.
Supports consideration of vasospasm after blunt chest trauma; extends single prior case but remains hypothesis-generating.
Coronary vasospasm is characterized by focal or diffuse spasm of an epicardial coronary artery. Definitive diagnosis is usually made with coronary angiography, when resolution of stenosis is observed after administration of intracoronary vasodilators. Coronary vasospasm is rarely a consequence of a blunt force injury to the chest. Among trauma induced cardiac complications, coronary vasospasm has been the least common with only one other reported case of coronary vasospasm induced by trauma. We report a rare case of severe spontaneous coronary vasospasm in a patient with polytrauma successfully treated with intracoronary, intravenous and oral vasodilator therapy. The mechanism is thought to be due to compensatory catecholamine response to trauma, and coronary vasospasm should be strongly suspected in trauma patients with unexplained hypotension, new conduction abnormalities or evidence of ischemia on the ECG.
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Huynh et al. (2019) studied this question.
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