Death from undetected acute myocardial infarction secondary to coronary artery dissection after blunt thoracic trauma
| Autor: | Somboon Thamtakerngkit, Suree Lekawanvijit, Supot Puanglumyai |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Acute decompensated heart failure Thoracic Injuries Myocardial Infarction Autopsy 030204 cardiovascular system & hematology Anterior Descending Coronary Artery Chest pain Pathology and Forensic Medicine 03 medical and health sciences Young Adult 0302 clinical medicine Blunt Fatal Outcome Internal medicine medicine Humans cardiovascular diseases 030212 general & internal medicine Myocardial infarction Interventricular septum business.industry Accidents Traffic Coronary Aneurysm General Medicine medicine.disease Pulmonary edema Coronary Vessels Surgery Aortic Dissection medicine.anatomical_structure cardiovascular system Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology. 25(2) |
| ISSN: | 1879-1336 |
| Popis: | Blunt thoracic trauma is a common occurrence in automobile accidents. Acute myocardial infarction (AMI) caused by coronary dissection following blunt thoracic trauma is rare. We report a case of healthy 24-year-old man with a history of blunt thoracic injury with subsequent undetected AMI who died of acute decompensated heart failure 4 days after the insult. The autopsy findings showed a 90% luminal narrowing of the left anterior descending coronary artery by dissecting hematoma, 3 cm in length. The myocardium revealed transmural myocardial infarction affecting apex, most part of left ventricular free wall, and interventricular septum. Both lungs were heavy, wet, and noncrepitant. Histological findings of the infarcted myocardium were consistent with 3-5 days post-AMI. Sections from both lungs revealed massive pulmonary edema, reflecting acute decompensated heart failure following a large AMI secondary to coronary dissection. Blunt thoracic trauma may obscure typical chest pain associated with cardiac ischemia especially in cases with a high tolerance for pain. |
| Databáze: | OpenAIRE |
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