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Acute myocardial infarction following penetrating thoracic trauma: A case report and review of literature
- Source :
- International Journal of Surgery Case Reports
- Publication Year :
- 2019
- Publisher :
- Elsevier, 2019.
-
Abstract
- Highlights • AMI as a result of penetrating thoracic trauma is rare, but can occur secondary to an acute thrombus, even in the absence of a direct cardiac injury. • Regardless of the cause of AMI, medical management should follow current guidelines.<br />Introduction Acute myocardial infarction (AMI) as a result of penetrating thoracic trauma (PTT) is rare; however, there have been a few reports of AMI from gunshot wounds. Presentation of case A patient without a history of coronary artery disease (CAD) presented with stab wounds to the left chest and underwent a left anterior thoracotomy, left lung wedge resection, negative pericardial window, and negative exploratory laparotomy. Shortly after leaving the operating room (OR) in a stable condition, the patient experienced a STEMI. An acute thrombus in the proximal left anterior descending (LAD) artery was identified. Discussion AMI as a result of trauma, both blunt and penetrating, is extremely rare. There have been more reports of AMI secondary to blunt trauma, but it is much less common to find reports in literature of AMI from PTT. Conclusion AMI as a result of penetrating trauma is rare, but can occur secondary to an acute thrombus, even in the absence of a direct cardiac injury. MI should be a consideration in patients with penetrating trauma to the chest, regardless of the intensity of the trauma. At minimum, a 12-lead electrocardiogram (ECG) and a baseline troponin should be obtained at initial evaluation and post-operatively, if surgically managed. If ECG demonstrates findings concerning for MI, it should be followed with an echocardiogram and/or cardiac angiogram to further help guide management, with an early cardiology consultation.
- Subjects :
- medicine.medical_specialty
Exploratory laparotomy
medicine.medical_treatment
health care facilities, manpower, and services
CAD, coronary artery disease
ASA, aspirin
TTE, transthoracic echocardiogram
FFP, fresh frozen plasma
SBTs, spontaneous breathing trials
Acute myocardial infarction
Article
Coronary artery disease
03 medical and health sciences
LAD, left anterior descending
0302 clinical medicine
STEMI, ST elevation myocardial infarction
Internal medicine
MTP, Massive transfusion protocol
BB, beta blocker
medicine
OR, operating room
BTT, blunt thoracic trauma
Myocardial infarction
Thoracotomy
cardiovascular diseases
Thrombus
health care economics and organizations
Penetrating trauma
business.industry
SBP, systolic blood pressure
medicine.disease
pRBCs, packed red blood cells
ARB, angiotensin II receptor blocker
Pericardial window
AMI, acute myocardial infarction
PTT, penetrating thoracic trauma
HD, hospital day
ST elevation myocardial infarction
Blunt trauma
HTN, hypertension
Penetrating thoracic trauma
030220 oncology & carcinogenesis
Cardiology
cardiovascular system
030211 gastroenterology & hepatology
Surgery
LLL, left lower lobe
business
Subjects
Details
- Language :
- English
- ISSN :
- 22102612
- Volume :
- 65
- Database :
- OpenAIRE
- Journal :
- International Journal of Surgery Case Reports
- Accession number :
- edsair.doi.dedup.....1221830aa64ac870a59b899feedaf627