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Title: [Subacute anterior myocardial infarction after mild blunt chest trauma in a 32-year-old man]. Author: Halboos A, Jacksch R. Journal: Dtsch Med Wochenschr; 2012 Feb; 137(5):214-6. PubMed ID: 22278693. Abstract: HISTORY AND CLINICAL FINDING: A 32-year-old man came to the surgical department because of persisting retrosternal pain radiating to the left side of the thorax for two days. During a move an armchair had slipped out of his hands and caused a mild blunt chest trauma. The further clinical examination findings were unremarkable. INVESTIGATIONS: Echocardiography was performed to rule out myocardial contusion. It showed a slightly reduced left-ventricular ejection fraction (EF 52 %) with akinesia of all apical segments overlapping to the septal and anterolateral wall, reaching the mid-ventricular area. The electrocardiogram (ECG) revealed a complete loss of R voltage of the anterior wall with persisting ST elevations in V4-V6. Coronary angiography showed a short-length thrombotic occlusion of the left anterior descending artery (LAD) immediately after giving off the diagonal branch, based on a plaque-rupture. TREATMENT AND COURSE: Because of the subacute myocardial infarction in combination with a bifurcation problem a drug-eluting stent was inserted in accordance with current studies. Initial cardiac MRT showed slightly reduced left-ventricular ejection fraction (EF 50 %), while myocardial wall thickness was preserved in all segments. Four weeks later severe myocardial remodeling had caused transmural scar formation of the anterior wall which had resulted in a reduction of left-ventricular EF to 39 %. CONCLUSION: Myocardial infarction based on plaque-rupture can occur after a mild blunt chest trauma even in young patients. An early cardiological examination, at least an ECG, should be performed to avoid complications of mild, painful blunt chest trauma.[Abstract] [Full Text] [Related] [New Search]