Chun J H, Lee S C, Gwon H C, Lee S H, Hong K P, Seo J D, Lee W R
Department of Medicine, Sungkyunkwan University, College of Medicine, Samsung Medical Center, Seoul, Korea.
J Korean Med Sci. 1998 Jun;13(3):325-7. doi: 10.3346/jkms.1998.13.3.325.
Coronary artery injury after blunt chest trauma is very rare, but this can result in a serious acute myocardial infarction. Coronary artery dissection is an uncommon complication of thoracic injuries. We report a case of a 17-year-old male who was presented with an anterior myocardial infarction following blunt chest trauma after a bicycle accident. His coronary angiography revealed aneurysmal dilatation with dissection of the distal left main stem coronary artery. Intravascular ultrasound showed a dissecting flap at the left main stem coronary artery. The patient was treated conservatively and discharged without serious sequelae. When symptoms and electrocardiographic findings are compatible with acute myocardial infarction, careful evaluation is important in patients with thoracic injuries for proper management. If the patient is stable, medical therapy may be appropriate. But early intervention should be considered in the presence of ongoing myocardial ischemia.
钝性胸部创伤后冠状动脉损伤非常罕见，但这可能导致严重的急性心肌梗死。冠状动脉夹层是胸部损伤的一种罕见并发症。我们报告一例17岁男性，在自行车事故后钝性胸部创伤后出现前壁心肌梗死。他的冠状动脉造影显示左主干冠状动脉远端有动脉瘤样扩张并伴有夹层。血管内超声显示左主干冠状动脉有一个夹层瓣。患者接受了保守治疗，出院时没有严重后遗症。当症状和心电图表现与急性心肌梗死相符时，对胸部损伤患者进行仔细评估对于正确管理非常重要。如果患者病情稳定，药物治疗可能是合适的。但在存在持续性心肌缺血的情况下应考虑早期干预。
