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Case Reports
. 2018 Jun 18;18(1):118.
doi: 10.1186/s12872-018-0861-x.

Acute myocardial infarction after blunt chest wall trauma with underlying coronary aneurysm: a case report

Xu Guo  1 , Xiaoou Wang  1 , Xinzhong Zhang  1 , Ahmed O Ahmed  1 , David H Hsi  2 , Daqing Zhang  3
Affiliations
Case Reports

Acute myocardial infarction after blunt chest wall trauma with underlying coronary aneurysm: a case report

Xu Guo et al. BMC Cardiovasc Disord. .

Abstract

Background: Kawasaki disease is an acute febrile disease with mucocutaneous and cardiovascular involvement affecting infants and young children. Though coronary artery abnormalities are common in Kawasaki disease, no consensus has been reached regarding the treatment of acute coronary artery diseases in this population.

Case presentation: We described a case of myocardial infarction triggered by blunt chest wall trauma in a 20 years old girl. She presented with chest pain and breathlessness with brief syncope, lab results and electrocardiogram findings were consistent with acute myocardial infarction. Chest computer tomography (CT) demonstrated coronary artery calcifications and echocardiography revealed multiple giant left anterior descending aneurysms, suggestive of Kawasaki disease. Subsequent contrast enhanced 3 dimensional coronary computer tomography angiography (CTA) confirmed these findings. We managed this young patient with a conservative strategy. The patient remained symptom free during 2-years follow-ups.

Conclusions: Prompt medical treatment for traumatic myocardial infarction even with underlying giant coronary artery aneurysms can successfully preserve left ventricular function and prevent remodeling with good short term prognosis.

Keywords: Acute coronary syndrome; Coronary artery aneurysm; Echocardiography; Kawasaki disease.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and accompanying images.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Dynamic ECG changes after blunt chest wall trauma. a ECG on admission: sinus rhythm with QS complexes in leads V2 to V3, ST segment elevations and T-wave inversions in leads V2 to V5. b ECG at the 2-month follow-up: leads V2 and V3 with QS complex and resolution of the other acute changes
Fig. 2
Fig. 2
Coronary artery aneurysm of the left anterior descending artery. a Chest computer tomography (CT): ringed calcification with 9.8 mm diameter in the left anterior descending (LAD) artery. b Trans-thoracic echocardiography: the proximal aneurismal dilation of the LAD artery. c Coronary CT angiography(CTA) image in orthogonal plane: LAD artery aneurysm. d Coronary CTA with three-dimensional volume rendering: multiple giant aneurysms with lumen occlusion and distal re-canalization in the LAD artery (arrows)
See this image and copyright information in PMC

References

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