• Se Jung Yoon, Hyuck Moon Kwon, Dong Soo Kim, Bum Kee Hong, Dong-Yeon Kim, Yun-Hyeong Cho, Byung Seung Kang, and Hyun-Seung Kim.
• Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
• Yonsei Med. J. 2003 Aug 30; 44 (4): 736739736-9.

AbstractChest trauma can lead to various cardiac complications ranging from simple arrhythmias to myocardial rupture. An acute myocardial infarction (AMI) is a rare complication that can occur after chest trauma. We report a case of 66-year-old male who suffered a blunt chest trauma from a traffic accident resulting in an AMI. The coronary angiography revealed an eccentric 50% narrowing of the ostium of left anterior descending artery (LAD) by a dissection flap with calcification. Intravascular ultrasonography (IVUS) revealed eccentric calcified plaque (minimal luminal diameter [MLD]=3.5 mm) with a dissection flap. Intervention was not performed considering the MLD and calcified flap, and he has been conservatively managed with aspirin and losartan for 2 years. The follow-up coronary angiography showed an insignificant luminal narrowing of the proximal LAD from the ostium without evidence of a dissection. An early coronary evaluation including an IVUS study should be considered for managing patients who complain of ongoing, deep-seated chest pain with elevated cardiac enzyme levels and an abnormal electrocardiogram (ECG) after a blunt chest trauma. Based on this case, some limited cases of traumatic coronary artery dissections can be healed with conservative management and result in a good prognosis.

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