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

Alexander Edo Tondas; Fredy Tandri; Edrian Zulkarnain

doi:10.30701/ijc.1140

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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