Citation

Shapiro MJ, Wittgen C, Flynn MS, Zuckerman DA, Durham RM, Mazuski JE. Clin. Cardiol. 1994; 17(3): 157-159.

Affiliation

Division of Trauma Surgery, St. Louis University Medical Center, MO 63110-0250.

Copyright

(Copyright © 1994, John Wiley and Sons)

DOI

unavailable

PMID

8168283

Abstract

The heart lies in a vulnerable position when the chest is subjected to direct blunt trauma. Acute occlusion of a coronary artery from blunt chest trauma is rare, with occlusion of the right coronary artery at its origin recorded only twice in the English literature. A young male unrestrained driver sustained an acute deceleration injury with significant chest trauma when he crashed, crushing the steering wheel against his chest. Creatine phosphokinase isoenzymes were initially 2% of the total and 8% 12 h later. There were marked electrocardiographic changes, and an echocardiogram revealed abnormal left ventricular systolic function with an akinetic inferior-posterior wall and right ventricular enlargement. A wide mediastinum and mechanism of injury led to the performance of aortography which failed to disclose a right coronary vessel. Subsequently coronary angiography confirmed acute occlusion of the proximal right coronary artery. Because of other associated injuries, nonoperative medical management was successfully utilized.

Language: en