Acute myocardial infarction after blunt chest wall trauma with underlying coronary aneurysm: a case report

• Published in: BMC cardiovascular disorders Vol. 18; no. 1; pp. 118 - 4
• Main Authors: Guo, Xu, Wang, Xiaoou, Zhang, Xinzhong, Ahmed, Ahmed O., Hsi, David H., Zhang, Daqing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.06.2018; BioMed Central; BMC
• Subjects: Acute coronary syndrome; Acute coronary syndromes; Analysis; Aneurysm; Aneurysms; Angiography; Baseball - injuries; Blood clots; Calcification; Care and treatment; Case Report; Case reports; Chest; Children; Computed Tomography Angiography; Conservative Treatment; Coronary Angiography - methods; Coronary artery; Coronary artery aneurysm; Coronary vessels; Echocardiography; EKG; Electrocardiography; Female; Flow velocity; Heart; Heart Aneurysm - diagnostic imaging; Heart Aneurysm - etiology; Heart Aneurysm - therapy; Heart attack; Heart attacks; Humans; Infants; Kawasaki disease; Left ventricular function; Medical imaging; Mucocutaneous lymph node syndrome; Mucocutaneous Lymph Node Syndrome - complications; Mucocutaneous Lymph Node Syndrome - diagnosis; Mucocutaneous Lymph Node Syndrome - therapy; Myocardial infarction; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - etiology; Myocardial Infarction - therapy; Pain; Patients; Stents; Syncope; Thoracic Injuries - diagnosis; Thoracic Injuries - etiology; Thoracic Injuries - therapy; Thrombosis; Tomography; Trauma; Treatment Outcome; Veins & arteries; Ventricle; Wounds, Nonpenetrating - diagnosis; Wounds, Nonpenetrating - etiology; Wounds, Nonpenetrating - therapy; Young Adult; Japan; Echocardiography; Kawasaki disease; Acute coronary syndrome; Coronary artery aneurysm
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-018-0861-x

Kawasaki disease is an acute febrile disease with mucocutaneous and cardiovascular involvement affecting infants and young children. Though coronary artery abnormalities are common in Kawasaki disease, no consensus has been reached regarding the treatment of acute coronary artery diseases in this population. We described a case of myocardial infarction triggered by blunt chest wall trauma in a 20 years old girl. She presented with chest pain and breathlessness with brief syncope, lab results and electrocardiogram findings were consistent with acute myocardial infarction. Chest computer tomography (CT) demonstrated coronary artery calcifications and echocardiography revealed multiple giant left anterior descending aneurysms, suggestive of Kawasaki disease. Subsequent contrast enhanced 3 dimensional coronary computer tomography angiography (CTA) confirmed these findings. We managed this young patient with a conservative strategy. The patient remained symptom free during 2-years follow-ups. Prompt medical treatment for traumatic myocardial infarction even with underlying giant coronary artery aneurysms can successfully preserve left ventricular function and prevent remodeling with good short term prognosis.