Biswas Saptarshi, Hristov Boris, Kinthala Sudhakar, Abrol Sunil
Department of Trauma, Acute Care Surgery and Surgical Critical Care, Forbes Hospital, Allegheny Health Network, Monroeville, PA, USA.
Department of Surgery, Florida International University School of Medicine, FL, USA.
Cardiol Res. 2019 Apr;10(2):114-119. doi: 10.14740/cr825. Epub 2019 Apr 11.
Penetrating cardiac injuries are highly lethal and carry high mortality rate. Both blunt and penetrating cardiac injuries in patients who survive are known to present with well-known sequelae that often appear days to weeks after the initial insult. In the literature there have been documented cases of cardiac injury induced myocardial infarction, ventricular aneurysms, valvular dysfunction and even fistulous tracts between the coronary vessels and chamber. Although the most commonly injured vessel is the left anterior descending (LAD) coronary artery, traumatic injuries to the left coronary artery result in early death in the majority of cases. We present a unique case of LAD pseudo aneurysm and stenosis presenting as acute coronary syndrome (ACS) months after the initial penetrating cardiac injury successfully managed by stenting. There are only few isolated case reports of coronary artery pseudoaneurysm following penetrating chest trauma published in English literature.
穿透性心脏损伤具有高度致死性，死亡率很高。已知存活患者的钝性和穿透性心脏损伤都会出现一些众所周知的后遗症，这些后遗症通常在初次受伤数天至数周后出现。文献中记载了心脏损伤导致心肌梗死、室壁瘤、瓣膜功能障碍甚至冠状动脉与心腔之间形成瘘管的病例。虽然最常受伤的血管是左前降支（LAD）冠状动脉，但左冠状动脉的创伤性损伤在大多数情况下会导致早期死亡。我们报告了一例独特的病例，患者在初次穿透性心脏损伤数月后出现左前降支假性动脉瘤和狭窄，并表现为急性冠状动脉综合征（ACS），通过支架置入成功治疗。英文文献中仅有少数关于穿透性胸部创伤后冠状动脉假性动脉瘤的孤立病例报告。
