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Management of acute myocardial infarction after a blunt chest trauma.
MedLine Citation:
PMID:  23599204     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Coronary artery dissection is a rare complication after blunt chest trauma. Patients usually present with sudden death and the diagnosis is frequently missed. In this report, we present a case of a 46-year-old with a hyperacute anterior wall myocardial infarction after blunt chest trauma. Diagnostic coronary angiography showed total occlusion of the left anterior descending coronary artery (LAD) starting at the takeoff of the vessel from the left main coronary artery (LMCA). A bare-metal stent was immediately deployed at the proximal LAD and TIMI 3 flow was achieved; however post-procedural images revealed no satisfactory results. A proximal dissection and intraluminal thrombus extending to the LMCA was observed. Because of the proximity of the lesion to the LMCA, re-intervention was considered to be risky and urgent coronary artery bypass grafting (CABG) was planned. Coronary artery stenting is the advised treatment modality for coronary occlusion after blunt chest trauma. However, post-traumatic percutaneous coronary intervention was sometimes considered to be risky because of the anatomic features of the lesion. Timing is cardinal in achieving early reperfusion in the course of myocardial infarction after blunt chest trauma and CABG should be the preferred procedure for initial reperfusion treatment especially in proximal LAD dissections with subsequent thrombus formation leading to total occlusion of the artery.
Authors:
Oner Ozdoğan; Mustafa Karaçelik; Cenk Ekmekçi; Cengiz Ozbek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES     Volume:  19     ISSN:  1306-696X     ISO Abbreviation:  Ulus Travma Acil Cerrahi Derg     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-04-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274231     Medline TA:  Ulus Travma Acil Cerrahi Derg     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  173-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey. onerozdogan@yahoo.com.
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