Department of Surgery, University Hospital of Ludwig-Maximilians-University, Downtown Campus, Munich, Germany.
Resuscitation. 2011 Mar;82(3):358-60. doi: 10.1016/j.resuscitation.2010.10.021. Epub 2010 Dec 30.
We report on a trauma victim without history of or risk factors for cardiac disease, who suffered coronary artery dissection caused by blunt chest injury (BCI). Myocardial ischaemia was detected by multislice computed tomography (MSCT) promptly after trauma centre admission and managed by immediate revascularisation. Thoracic trauma may cause myocardial ischaemia in the absence of a specific risk profile. MSCT, as part of initial work-up in severely injured patients, may support differential diagnosis after BCI. Tirofiban and unfractionated heparin as short-acting anticoagulants warrant stent patency and concurrently offer the possibility of quick recovery of haemostasis in case of haemorrhage.
我们报告了一名无心脏病病史或风险因素的创伤患者,其因钝性胸部损伤(BCI)而发生冠状动脉夹层。创伤中心入院后立即通过多层螺旋 CT(MSCT)检测到心肌缺血,并立即进行血运重建。胸部创伤可在无特定风险因素的情况下引起心肌缺血。MSCT 作为严重损伤患者初始检查的一部分,在 BCI 后可能有助于鉴别诊断。替罗非班和普通肝素作为短期抗凝剂可确保支架通畅,并在发生出血时提供快速恢复止血的可能性。