A case of post-traumatic coronary occlusion

H Y Lee, Y M Ju, M H Lee, S J Lee, W H Chang, C W Imm, H Y Lee, Y M Ju, M H Lee, S J Lee, W H Chang, C W Imm

Abstract

Several cases of transmural myocardial infarction and ventricular aneurysm caused by a blunt trauma of the chest have been reported. Nevertheless, the cases documented with coronary and ventricular angiography are very few. There has always been a debate over the etiological mechanism of such lesions. Since in some cases there was no evidence of coronary lesions, it was postulated that they were produced by direct myocardial contusion, but in other instances the evidence of coronary occlusion was angiographically and pathologically proved. We experienced a case of acute myocardial infarction with ventricular aneurysm secondary to nonpenetrating chest trauma by an umbrella tip and wish to report this unusual case, along with a review of the literature.

Figures

Fig. 1
Fig. 1
Electrocardiogram on admission. Abnormal Q waves with an ST elevation on leads V2–V4 are seen.
Fig. 2
Fig. 2
Left coronary arteriography in the right anterior oblique projection. A complete out-off of the left anterior descending coronary artery at the proximal segment is seen (arrow). No other lesion is observed.
Fig. 3
Fig. 3
Left end-systolic ventriculography in the right anterior oblique projection. An anteroapical aneurysm of the free ventricular wall is seen.

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