Key result
Emergent coronary angiography with intervention to the mid-LAD occlusion resolved cardiogenic shock in a 65-year-old man with blunt chest trauma, improving LVEF to 50% at one year.
Case Report (n=1)
Blunt chest trauma can lead to acute myocardial infarction via coronary thrombosis, which can be effectively managed with emergent percutaneous coronary intervention.
Post-traumatic STEMI warrants consideration after chest injury; this Level 5 case leaves open incidence and management strategies.
A 65-year-old man presented to the emergency department following an anterior chest trauma. He had significant chest pain and chest X-ray was significant for revealed multiple rib fractures and negative. CT scan of the chest ruled out pulmonary embolism or aortic dissection. However, few hours later he developed hypotension requiring admission to medical intensive care unit and intravenous vasopressors. Further workup showed ST elevation myocardial infarction involving the anterior ECG leads. Emergent coronary angiography was performed with intervention to the mid-left anterior descending occlusion. Cardiogenic shock resolved and patient was discharged few days later. One-year follow-up with echocardiogram showed stable ischaemic cardiomyopathy with improved left ventricular ejection fraction to 50%.
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Treuth et al. (2014) conducted a case report in Acute myocardial infarction due to coronary thrombosis caused by blunt chest trauma (n=1). Emergent coronary angiography with intervention to the mid-left anterior descending occlusion was evaluated on Resolution of cardiogenic shock and left ventricular ejection fraction improvement. Emergent coronary angiography with intervention to the mid-LAD occlusion resolved cardiogenic shock in a 65-year-old man with blunt chest trauma, improving LVEF to 50% at one year.
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