Baccouche Hannibal, Beck Torsten, Maunz Martin, Fogarassy Peter, Beyer Martin
Medizinische Klinik II, Klinikum Kirchheim unter Teck, Kreiskliniken Esslingen, Germany.
J Cardiovasc Magn Reson. 2009 Oct 11;11(1):39. doi: 10.1186/1532-429X-11-39.
Cardiac injury occasionally occurs as a result of blunt chest trauma. Most cardiac complications in chest trauma are due to myocardial contusion rather than direct damage to the coronary arteries. However, traumatic coronary injury has been reported, and a variety of underlying pathophysiological mechanisms have been proposed. We present a 26 year old patient presenting with an acute coronary syndrome as a consequence of a soccer-shot impact to the chest. CMR showed apical inferior infarction, as well as multiple small septal lesions which were presumed to have resulted from embolization. The culprit lesion was a proximal 75% LAD stenosis with a prominent plaque-rupture and thrombus-formation, and the distal LAD was occluded by thromboembolic material.
心脏损伤偶尔会因钝性胸部创伤而发生。胸部创伤中的大多数心脏并发症是由于心肌挫伤，而非冠状动脉的直接损伤。然而，已有创伤性冠状动脉损伤的报道，并提出了多种潜在的病理生理机制。我们报告一名26岁患者，因胸部受到足球撞击而出现急性冠状动脉综合征。心脏磁共振成像显示心尖下壁梗死，以及多个小的室间隔病变，推测是由栓塞所致。罪犯病变是左前降支近端75%狭窄，伴有明显的斑块破裂和血栓形成，左前降支远端被血栓栓塞物质阻塞。
