Myocardial Infarction Secondary to Blunt Chest Trauma

Abstract

Myocardial infarction (MI) following blunt chest trauma is rare, but potentially fatal. We treated a young patient for acute MI after falling chest-first on ice while playing hockey. Coronary artery bypass grafting (CABG) was performed after percutaneous stenting attempts were unsuccessful. By reviewing the related literature, we found 179 cases, the majority of which affected young males following road accidents. Left anterior descending artery was most frequently affected followed by right coronary artery particularly in their proximal thirds. Prior to the advent of emergent angioplasty for MI, conservative management was frequently pursued, whereas subsequently both stenting and CABG were performed as initial therapy. Several cases required CABG after the failure of stenting attempts. Trauma-associated MI is uncommon but should be suspected to be properly diagnosed and managed; the potential need for CABG requires that a cardiac surgeon be informed at the time of angiography to avoid possible delay in revascularization.

Keywords: Chest pain; Coronary artery bypass; Coronary vessels; Myocardial infarction; Percutaneous coronary intervention.