Coronary artery rupture in blunt thoracic trauma: a case report and review of literature

J Cardiothorac Surg. 2016 Aug 2;11(1):119. doi: 10.1186/s13019-016-0528-6.

Abstract

Background: Blunt thoracic trauma can rarely result in coronary artery injury. Blunt trauma can result in occlusion of any of the coronary arteries or can lead to its rupture and bleeding. Traumatic coronary artery occlusion can lead to myocardial infarction, while its rupture and bleeding can result in hemopericardium and cardiac tamponade, and can be rapidly fatal. Survival after coronary artery rupture in blunt thoracic trauma is exceedingly rare.

Case presentation: We present a case of a young male who sustained a blunt thoracic trauma in a motor vehicle collision, that resulted in rupture of the left anterior descending (LAD) coronary artery and subsequent cardiac tamponade. Prompt surgical intervention with pericardiotomy and ligation of the artery has resulted in survival of the patient.

Conclusions: In cases of traumatic coronary artery rupture, early surgical intervention is crucial to avoid mortality. Ligation of the injured coronary is a viable option in selected cases, and can be the most expeditious option in patients in extremis.

Keywords: Blunt trauma; Case report; Coronary artery rupture; Left anterior descending (LAD) coronary artery; Thoracic trauma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Accidents, Traffic
  • Adult
  • Cardiac Tamponade / etiology
  • Cardiac Tamponade / surgery*
  • Coronary Vessels / injuries*
  • Coronary Vessels / surgery*
  • Humans
  • Ligation
  • Male
  • Pericardiectomy
  • Rupture
  • Thoracic Injuries / complications*
  • Wounds, Nonpenetrating / complications*