A 21-year-old man has motorcycle accident taken to the shock room. The patient is awake, oriented and complains of thoracic pain. There are no previous illnesses and no cardiovascular risk factors. The physical examination, FAST sonography and polytrauma computed tomography reveal rib fractures and lung contusions. The ECG confirms the suspicion of myocardial ischemia, so cardiologist is called in in the emergency room. The patient is immediately coronary angiographed; A traumatic, proximal RIVA dissection is shown, and IVUS (intravascular ultrasound) -controlled direct stenting of the lesion is performed. The patient can be discharged home six days after the trauma with slightly reduced left ventricular pump function in echocardiography. Acute coronary injuries following blunt chest trauma are rare and life-threatening. The case underlines the necessity of the 12-lead ECG, quick action and interdisciplinarity in emergency room management.
Dr. med. Leif Ilja Bösche , Cardiology and Angiology, Bergmannsheil University Clinic of Employers' Liability Insurance Association
Prof. Dr. med. Thomas Armin Schildhauer , Dr. med. Uwe Hamsen , Surgical Clinic, University Hospital Bergmannsheil, Bochum, uwe.hamsen@bergmannsheil.de
Conflict of interest: The authors explain, that there is no conflict of interest.
Citation: Bösche LI, Schildhauer TA, Hamsen U: A 21-year-old man with coronary artery dissection after blunt trauma to the chest. Dtsch Arztebl Int 2018; 115: 209. DOI: 10.3238 / arztebl.2018.0209
►The German version of this article is available online: www.-international.de
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