Acute myocardial infarction secondary to blunt chest trauma in motorcycle accident: A rare combination where percutaneous coronary intervention and intravascular imaging optimization are needed.
Alberto BoiFrancesco SannaAngelica RossiBruno LoiPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2018)
Blunt chest trauma is a common occurrence in vehicle accident. Cardiac injuries following nonpenetrating thoracic trauma have been reported. ST-elevation myocardial infarction (STEMI) due to coronary artery involvement is a rare but extremely serious condition for the high risk of undetected diagnosis. Blunt thoracic trauma may obscure typical chest pain associated with cardiac ischemia especially in patients with high tolerance of pain or secondary administration of analgesic drugs. We report two consecutive cases of young adults admitted to our emergency department after motorcycle accident and concomitant anterior STEMI due to occlusion of left anterior descending artery. In both cases primary percutaneous coronary intervention with a second generation drug eluting stent implantation was successfully performed. Imaging with intravascular ultrasound and optical coherence tomography showed the mechanisms of coronary occlusion, allowing an optimal stent implantation and avoiding procedural complications in this complex setting.
Keyphrases
- percutaneous coronary intervention
- st elevation myocardial infarction
- trauma patients
- acute myocardial infarction
- coronary artery
- coronary artery disease
- st segment elevation myocardial infarction
- acute coronary syndrome
- antiplatelet therapy
- coronary artery bypass grafting
- emergency department
- young adults
- pulmonary artery
- high resolution
- optical coherence tomography
- coronary artery bypass
- left ventricular
- atrial fibrillation
- neuropathic pain
- magnetic resonance imaging
- spinal cord
- pulmonary arterial hypertension
- chronic pain
- risk assessment
- computed tomography
- pulmonary hypertension
- heart failure
- diabetic retinopathy
- pain management
- electronic health record
- fluorescence imaging
- ultrasound guided