• Thung-Lip Lee, Chin-Feng Hsuan, Chen-Hsiang Shih, Huai-Wen Liang, Hsing-Shan Tsai, Wei-Kung Tseng, and Kwan-Lih Hsu.
• Division of Cardiology, Department of Internal Medicine, E-Da hospital / I-Shou University, Kaohsiung, Taiwan.
• Bmc Cardiovasc Disor. 2017 Feb 10; 17 (1): 56.

BackgroundBlunt cardiac trauma encompasses a wide range of clinical entities, including myocardial contusion, cardiac rupture, valve avulsion, pericardial injuries, arrhythmia, and even myocardial infarction. Acute myocardial infarction due to coronary artery dissection after blunt chest trauma is rare and may be life threatening. Differential diagnosis of acute myocardial infarction from cardiac contusion at this setting is not easy.Case PresentationHere we demonstrated a case of blunt chest trauma, with computed tomography detected myocardium enhancement defect early at emergency department. Under the impression of acute myocardial infarction, emergent coronary angiography revealed left anterior descending artery occlusion. Revascularization was performed and coronary artery dissection was found after thrombus aspiration. Finally, the patient survived after coronary stenting.ConclusionPerfusion defects of myocardium enhancement on CT after blunt chest trauma can be very helpful to suggest myocardial infarction and facilitate the decision making of emergent procedure. This valuable sign should not be missed during the initial interpretation.

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