Traumatic Left Main Coronary Artery Dissection with Acute Myocardial Infarction after Chest Contusion

創傷性左冠動脈主幹枝剝離併急性心肌梗塞

吳耿逸(Keng-Yi Wu) ； 賴昭宏(Jou-Hong Lai)

《內科學誌》 27卷5期 (2016/10) Pp. 261-266

https://doi.org/10.6314/JIMT.2016.27(5).05

摘要

Blunt chest contusion can rarely induce coronary artery dissection with myocardial infarction. Clinical symptoms, electrocardiography, and serial cardiac enzyme evaluations are necessary in patients with thoracic trauma. Angioplasty or bypass surgery is chosen according to the lesion characteristics and associated complications. Here, we report a case of a dissected flap from the left main coronary artery to the left anterior descending coronary artery in a 63-year-old man with acute myocardial infarction secondary to blunt chest trauma during a traffic accident.

關鍵字

Chest contusion ； Coronary artery dissection ； Myocardial infarction

並列摘要

一名63 歲男性，無心血管病史及抽菸習慣，此次因騎乘摩托車時發生車禍，導致臉部及前胸有多處擦傷及挫傷，且造成鼻骨及右大腿骨折，而轉至急診求診，於等待行右腿骨折外固定術時，病患突然發生胸悶、冒冷汗等典型冠心症症狀且併有心電圖異常，進而緊急安排心導管檢查手術，檢查結果發現左冠狀動脈主幹枝剝離且併發左側冠狀動脈遠端血流減少之情況，經緊急行血管內支架置放術治療後，該病患於入院二十天後順利出院，且無相關之併發症發生。