Das Souvik K, Itty Charles, Vaishnav Manan, Mumford Drew
Basic Physician Training Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Cardiology, Lismore Base Hospital, Lismore, New South Wales, Australia.
Intern Med J. 2020 Jul;50(7):880-882. doi: 10.1111/imj.14904.
Traumatic coronary artery (CA) dissection is an extremely rare sequela of blunt chest trauma. Diagnosis of CA dissection in the setting of chest trauma is challenging. While conventionally coronary angiography has been the diagnostic tool of choice, modern imaging techniques such as optical coherence tomography can further improve diagnostic accuracy and help optimise treatment strategy. The ideal treatment modality for managing CA dissection has not been established with case reports revealing a range of treatment strategies ranging from CA bypass grafting to a completely conservative management. Here we present a case report of a 68-year-old man who suffered a traumatic proximal left anterior descending artery dissection as a consequence of a motor-vehicle accident and was subsequently treated with a combination of conservative and interventional strategy with optimal patient outcome.