Background: Coronary injury after blunt chest trauma is rare. This case illustrates the importance of evaluating for coronary injury after any episode of blunt chest wall trauma.
Case summary: We review the case of a 27-year-old male who presented with acutely decompensated heart failure several months after a motor vehicle accident with chest wall impact from the steering wheel. Coronary angiography demonstrated an occluded left anterior descending artery, and he was found to have a severe ischaemic cardiomyopathy. After multiple hospital and intensive care unit admissions due to multi-organ dysfunction and debility, he was unable to tolerate any guideline-directed medical therapy. He was unable to be listed for heart transplantation due to his co-morbidities, multi-system sequelae of his heart failure, deconditioning, and recent substance use. He was ultimately discharged home with hospice.
Conclusion: Coronary or other cardiac injuries should be considered in the evaluation of all patients after blunt chest wall trauma, regardless of prior risk factors for ischaemia.
Keywords: Case report; Coronary artery injury; Ischaemic cardiomyopathy; Traumatic cardiac injury.
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.