Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2016;69:213 - Vol. 69 Num.02 DOI: 10.1016/j.rec.2015.06.023

Coronary Hematoma After Thoracic Trauma

Miguel Rodríguez-Santamarta a,, Daniel Mera Fernández b, Carlos Delgado Sánchez-Gracián b

a Servicio de Cardiología, Complejo Asistencial Universitario de León, León, Spain
b Servicio de Radiología, Hospital POVISA, Vigo, Pontevedra, Spain

Article

A 30-year-old man with no cardiovascular risk factors presented to the emergency department complaining of chest pain. He reported receiving a hard blow to the chest while playing handball in the hours preceding symptom onset. At the time of his arrival at the emergency department, the chest pain persisted, and the electrocardiogram showed a horizontal ST segment in the inferior leads. Tests for early markers of myocardial injury were negative. Given that the patient had a low probability of coronary artery disease and that the electrocardiogram was nondiagnostic, we decided to screen for coronary artery disease using computed tomography coronary angiography. This study revealed severe stenosis in proximal right coronary artery produced by an intramural hematoma that was putting pressure on the artery at that level (Figure 1, Figure 2). In view of the computed tomographic findings, the patient was scheduled for invasive coronary angiography, which confirmed the diagnosis (Figure 3), and percutaneous treatment involving the implantation of a drug-eluting stent was undertaken. After the procedure, the patient remained asymptomatic and was discharged from the hospital without complications.

Figure 1.

Figure 2.

Figure 3.

The most common cause of chest trauma in young persons is traffic accidents. However, nonsevere blunt chest trauma, such as that occurring in sports, can result in coronary artery injury. Computed tomography coronary angiography is the most accurate procedure for the diagnosis of this condition, and percutaneous intervention could prevent the possible complications of coronary artery lesions of this type.

Corresponding author: mrsantamart@gmail.com

1885-5857/© 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

Cookies
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.
Cookies policy
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.