Traumatic Coronary Artery Dissection as A Potential Cause of Acute Myocardial Infraction in Motorcycle Accident

  • Alexander Edo Tondas Department of Cardiology and Vascular Medicine Department, Dr. Mohammad Hoesin General Hospital, Palembang, South Sumatera, Indonesia
  • Fredy Tandri Charitas Hospital Palembang, Palembang, South Sumatera, Indonesia
  • Edrian Zulkarnain Department of Cardiology and Vascular Medicine Department, Dr. Mohammad Hoesin General Hospital, Palembang, South Sumatera, Indonesia
Keywords: Blunt Chest Trauma, Traumatic Coronary Artery Dissection, Atrial Fibrillation, Motorcycle Collision

Abstract

Background: Chest pain in blunt chest trauma can be caused by various intrathoracic injuries. Pneumothorax, hemothorax, and rib fractures are commonly seen in the emergency department. Although cardiac involvement is very rare, the probability should not be excluded.

Case Illustration: A-31-years-old male who complained of chest pain and diaphoresis was brought to the emergency department after a high-speed motorcycle collision. Chest X-ray revealed no abnormality but a 12-lead Electrocardiogram (ECG) demonstrated ST-segment elevation in lead I, AvL, V2-6, and atrial fibrillation. Because of the unusual presentation, the decision was to proceed with percutaneous coronary intervention (PCI). Coronary Angiography detected a thrombus at proximal LAD and spiral dissection at mid LAD (TIMI 2 Flow). After the procedure, he was transferred to the High Care Unit.

Conclusion: Following blunt chest trauma, chest pain in the setting of a vehicle collision can be caused by dissection of the coronary artery. Prompt cardiac workup (ECG, cardiac enzyme, and echocardiography) must be done in a highly suspected patient.

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References

1. Sharonne N, Esther S, Jacqueline S, et al. Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association. Circulation. 2018;137(19):e523-e557.
2. Lobay KW, MacGougan CK: Traumatic coronary artery dissection: a case report and literature review. J Emerg Med. 2012;43:239-243.
3. Gert-Jan A, Caroline M, Koenraad N. Traumatic Coronary Artery Dissection with Secondary Acute Myocardial Infarction after Blunt Thoracic Trauma. Journal of the Belgian Society of Radiology. 2018;102(1):4,pp.1–3.
4. Elgendy M S, Mahfood Haddad T, Akinapelli A, et al. A Rare Case of Traumatic Coronary Artery Dissection After a Motor Vehicle Collision. Cureus. 2019;11(3):e4345.
5. Van Mieghem NM, van Weenen S, Nollen G, Ligthart J, Regar E, van Geuns RJ. Traumatic coronary artery dissection: potential cause of sudden death in soccer. Circulation. 2013;127(3):e280-2.
6. Ginzburg E, Dygert J, Parra-Davila E, Lynn M, Almeida J, Mayor M: Coronary artery stenting for occlusive dissection after blunt chest trauma. J Trauma Acute Care Surg. 1998; 45:157-161.
7. Rovshan M, Roberta B, Carol K, Evelyn O, Hank B. Trauma Associated With Cardiac Dysrhythmias: Results From a Large Matched Case-Control Study. The Journal of Trauma: Injury, Infection, and Critical Care. 2007;62(5):1186-1191.
8. Turgut K, Yucel N, Oğuzturk H, Ulutaş Z, Afşin A. Atrial Fibrillation due to Blunt Cardiac Injury: Case Report. J Emerg Med Case Rep. 2018;9(4):77-9.
9. Ota K, Bratincsak A. Atrial fibrillation induced by commotio cordis secondary to a blunt chest trauma in a teenage boy. Pediatrics. 2015;135(1):e199-201.
10. Huang K, Lu M, Liu K, Liu E, Chu J, Tsai F, Lin P. Traumatic pericardial effusion: impact of diagnostic and surgical approaches. Resuscitation. 2010 Dec;81(12):1682-6.
11. Edward R, Lawrence W, Mohamed M, Todd C. Early Recanalization of a Traumatic Coronary Artery Dissection With Medical Therapy Alone. JACC: Case Reports. 2020;2(15):2299-2303.
Published
2022-09-17
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How to Cite
Tondas, A., Tandri, F., & Zulkarnain, E. (2022). Traumatic Coronary Artery Dissection as A Potential Cause of Acute Myocardial Infraction in Motorcycle Accident. Indonesian Journal of Cardiology, 43(1), 23-9. https://doi.org/10.30701/ijc.1140