Citation

Haywood ST, Patel K, Gallo D, Silver K, Jouriles N. J. Emerg. Med. 2019; ePub(ePub): ePub.

Affiliation

Northeast Ohio Medical College, Rootstown, Ohio; Department of Emergency Medicine, Summa Health, Akron, Ohio.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.jemermed.2019.09.037

PMID

31744712

Abstract

BACKGROUND: The risk of cardiac injury in blunt thoracic trauma is quite rare, occurring in only 0.1% of patients. The least common cardiac injury is coronary artery dissection. Most cardiac injuries result from high-energy mechanisms such as motor vehicle collisions. Even low-mechanism injuries that have been reported involved rapid deceleration. CASE REPORT: We present a case of traumatic coronary artery dissection that resulted from a low-energy blunt thoracic injury with no rapid deceleration. This patient had no other associated thoracic injuries, such as rib fractures or sternal fracture. Following presentation, our patient twice deteriorated into ventricular fibrillation and was successfully resuscitated each time. The coronary lesion was successfully stented and the patient was eventually discharged home. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case underscores the importance of maintaining a high level of suspicion for coronary artery dissection even in low-energy mechanisms. An electrocardiogram should be obtained early, even in low-energy mechanisms. While patients with traumatic cardiac injuries will commonly present with other injuries, such as rib fractures, the absence of these injuries does not rule out cardiac injury.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en

Keywords

cardiac arrest; coronary dissection; myocardial infarction; myocardial injury; sports medicine; trauma