Oghlakian Gerard, Maldjian Pierre, Kaluski Edo, Saric Muhamed
Department of Medicine, New Jersey Medical School, Newark, NJ, USA.
Emerg Radiol. 2010 Mar;17(2):149-51. doi: 10.1007/s10140-009-0799-5. Epub 2009 Feb 13.
Cardiac complications of chest trauma range from arrhythmias to valvular avulsions to myocardial contusion, rupture, and rarely myocardial infarction. We describe a case of a young patient with blunt chest trauma after a motor vehicle accident in whom the diagnosis of myocardial infarction was established a week later because no electrocardiogram or cardiac biomarkers were obtained on presentation. Retrospective review of contrast-enhanced computed tomography (CT) of the chest done on presentation demonstrated a perfusion defect in the distribution of the left anterior descending artery (LAD). Subsequent coronary angiography demonstrated dissection in the proximal LAD. Our case illustrates the importance of electrocardiography and contrast-enhanced chest CT in initial evaluation of patients with blunt chest trauma and suspected injury to the coronary arteries.
胸部创伤的心脏并发症范围从心律失常到瓣膜撕裂，再到心肌挫伤、破裂，很少见心肌梗死。我们描述了一例年轻患者，在机动车事故后发生钝性胸部创伤，一周后确诊为心肌梗死，因为就诊时未进行心电图检查或检测心脏生物标志物。回顾性分析就诊时所做的胸部增强计算机断层扫描（CT）显示，左前降支动脉（LAD）分布区域存在灌注缺损。随后的冠状动脉造影显示LAD近端有夹层。我们的病例说明了心电图和胸部增强CT在钝性胸部创伤且怀疑冠状动脉损伤患者的初始评估中的重要性。
