초록접수 현황
| 19F-274 | 포스터 발표 |
Delayed Development of Coronary Artery Dissection after Blunt Chest Trauma
Joong Hwan Oh, Il Hwan Park, Soon Chang Hong, Chun Sung Byun, Chang Wan Kim
Department of thoracic and Cardiobascular Surgery, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Gangwon-do, Republic of Korea
Purpose : Coronary artery dissection after blunt trauma is rare condition but life threatening In almost all reported traumatic coronary dissection patients, cardiac marker elevation and ST change in electrocardiography reveals at patient’s hospital arrival.
Methods : We present a case of 63 year old male who developed the symptom of coronary artery dissection three days after trauma.
Results : A 63 year-old white male presented as a trauma patient after fall down accident from roof of cattle shed . Electrocardiography revealed atrial fibrillation and no ST change. Cardiac markers were with in normal range. Chest computed tomography showed Right lower lobe mild lung contusion , right 3-7th rib fracture, and mild right hemothorax. The patient was admitted to intensive care unit for close observation. On post trauma day 3rd, the patient complained of abdominal discomfort and showed sudden tachycardia. Electrocardiography revealed atrial fibrillation & ST elevation myocardial infarction. Emergency Coronary angiogram was performed. Coronary angiogram showed Right posterolateral branch total occlusion due to coronary artery dissection. Percutaneous coronary intervention was performed. Angioplasty was successful with placement of Resolute onyx 3.0/26 stent in the Right posterolateral branch. The patient moved to general ward on post trauma day 8th, and discharged on post trauma day 17th
Conclusion : coronary artery dissection is uncommon and fatal injury in blunt chest trauma. It is important to keep in mind the possibility of coronary artery dissection. As we learned in this case, delayed coronary artery dissection should not be misdiagnosed.
Methods : We present a case of 63 year old male who developed the symptom of coronary artery dissection three days after trauma.
Results : A 63 year-old white male presented as a trauma patient after fall down accident from roof of cattle shed . Electrocardiography revealed atrial fibrillation and no ST change. Cardiac markers were with in normal range. Chest computed tomography showed Right lower lobe mild lung contusion , right 3-7th rib fracture, and mild right hemothorax. The patient was admitted to intensive care unit for close observation. On post trauma day 3rd, the patient complained of abdominal discomfort and showed sudden tachycardia. Electrocardiography revealed atrial fibrillation & ST elevation myocardial infarction. Emergency Coronary angiogram was performed. Coronary angiogram showed Right posterolateral branch total occlusion due to coronary artery dissection. Percutaneous coronary intervention was performed. Angioplasty was successful with placement of Resolute onyx 3.0/26 stent in the Right posterolateral branch. The patient moved to general ward on post trauma day 8th, and discharged on post trauma day 17th
Conclusion : coronary artery dissection is uncommon and fatal injury in blunt chest trauma. It is important to keep in mind the possibility of coronary artery dissection. As we learned in this case, delayed coronary artery dissection should not be misdiagnosed.
책임저자: Joong Hwan Oh
Department of thoracic and Cardiobascular Surgery, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Gangwon-do, Republic of Korea
발표자: Chang Wan Kim, E-mail : asparag@naver.com