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. 2016:2016:8671015.
doi: 10.1155/2016/8671015. Epub 2016 Feb 23.

Coronary Thrombosis without Dissection following Blunt Trauma

Archana Sinha  1 , Michael Sibel  2 , Peter Thomas  3 , Francis Burt  1 , James Cipolla  3 , Peter Puleo  1 , Keith Baker  2
Affiliations

Coronary Thrombosis without Dissection following Blunt Trauma

Archana Sinha et al. Case Rep Cardiol. 2016.

Abstract

Blunt trauma to the chest resulting in coronary thrombosis and ST elevation myocardial infarction (STEMI) is a rare but well-described occurrence in adults. Angiography in such cases has generally disclosed complete epicardial coronary occlusion with thrombus, indistinguishable from the findings commonly found in spontaneous plaque rupture due to atherosclerotic disease. In all previously reported cases in which coronary interrogation with intravascular ultrasound (IVUS) was performed in association with acute revascularization, coronary artery dissection was implicated as the etiology of coronary thrombosis. We present the first case report of blunt trauma-associated coronary thrombosis without underlying atherosclerosis or coronary dissection, as documented by IVUS imaging.

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Figures

Figure 1
Figure 1
EKG showing ST segment elevation in leads V1, V2, and aVL and ST segment depressions in leads II, III, aVF, V5, and V6.
Figure 2
Figure 2
(a) Coronary angiogram showing total occlusion of LAD. (b) Restoration of normal flow following balloon dilation and stent deployment.
Figure 3
Figure 3
Intravascular ultrasound (IVUS) showing thrombus in proximal LAD, no evidence of dissection.
See this image and copyright information in PMC

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