外伤性冠状动脉破裂继发急性st段抬高型心肌梗死抢救1例。

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
European Heart Journal: Case Reports Pub Date : 2025-08-16 eCollection Date: 2025-09-01 DOI:10.1093/ehjcr/ytaf402
Guangfeng Sun, Shan Huang, Huiyuan Kang, Bin Wang
{"title":"外伤性冠状动脉破裂继发急性st段抬高型心肌梗死抢救1例。","authors":"Guangfeng Sun, Shan Huang, Huiyuan Kang, Bin Wang","doi":"10.1093/ehjcr/ytaf402","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Trauma-related acute myocardial infarction represents a complex and high-risk condition in the emergency department, necessitating a range of sophisticated treatment strategies. Failure to provide timely and accurate intervention significantly increases the risk of short-term mortality.</p><p><strong>Case summary: </strong>We present the case of a 36-year-old male who was admitted to local hospital following a penetrating chest trauma. Relevant diagnostic evaluations revealed haemopneumothorax and shock. Following initial stabilization measures, the patient was urgently transferred to our institution due to haemopericardium, which was initially suspected to be secondary to traumatic aortic dissection. However, the admission electrocardiogram clearly demonstrated concurrent anterior and high lateral wall myocardial infarction. Coronary angiography revealed occlusion of the left anterior descending (LAD) artery. We attempted interventional therapy on the LAD to restore blood flow. However, intraoperative findings revealed complete rupture of the LAD. The patient was transferred to the cardiac surgery department for emergency coronary artery bypass grafting (CABG). The foreign body was successfully retrieved, and the CABG was completed without complications. The patient gradually recovered under short-term ECMO support and was discharged successfully. Follow-up assessments indicate a favourable recovery.</p><p><strong>Discussion: </strong>The mechanism underlying traumatic myocardial infarction is complex and variable. Given that emergency physicians and cardiologists often lack extensive experience in such cases, they should exercise caution, conduct a thorough assessment, and meticulously plan each step of diagnosis and treatment.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 9","pages":"ytaf402"},"PeriodicalIF":0.8000,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405759/pdf/","citationCount":"0","resultStr":"{\"title\":\"Rescue of acute ST-elevation myocardial infarction secondary to traumatic coronary artery rupture: a case report.\",\"authors\":\"Guangfeng Sun, Shan Huang, Huiyuan Kang, Bin Wang\",\"doi\":\"10.1093/ehjcr/ytaf402\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Trauma-related acute myocardial infarction represents a complex and high-risk condition in the emergency department, necessitating a range of sophisticated treatment strategies. Failure to provide timely and accurate intervention significantly increases the risk of short-term mortality.</p><p><strong>Case summary: </strong>We present the case of a 36-year-old male who was admitted to local hospital following a penetrating chest trauma. Relevant diagnostic evaluations revealed haemopneumothorax and shock. Following initial stabilization measures, the patient was urgently transferred to our institution due to haemopericardium, which was initially suspected to be secondary to traumatic aortic dissection. However, the admission electrocardiogram clearly demonstrated concurrent anterior and high lateral wall myocardial infarction. Coronary angiography revealed occlusion of the left anterior descending (LAD) artery. We attempted interventional therapy on the LAD to restore blood flow. However, intraoperative findings revealed complete rupture of the LAD. The patient was transferred to the cardiac surgery department for emergency coronary artery bypass grafting (CABG). The foreign body was successfully retrieved, and the CABG was completed without complications. The patient gradually recovered under short-term ECMO support and was discharged successfully. Follow-up assessments indicate a favourable recovery.</p><p><strong>Discussion: </strong>The mechanism underlying traumatic myocardial infarction is complex and variable. Given that emergency physicians and cardiologists often lack extensive experience in such cases, they should exercise caution, conduct a thorough assessment, and meticulously plan each step of diagnosis and treatment.</p>\",\"PeriodicalId\":11910,\"journal\":{\"name\":\"European Heart Journal: Case Reports\",\"volume\":\"9 9\",\"pages\":\"ytaf402\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-08-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405759/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Heart Journal: Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjcr/ytaf402\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal: Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjcr/ytaf402","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

背景:创伤性急性心肌梗死在急诊科是一种复杂和高风险的疾病,需要一系列复杂的治疗策略。未能提供及时和准确的干预显著增加了短期死亡的风险。病例总结:我们提出的情况下,36岁的男性谁是住在当地医院穿透性胸部创伤。相关诊断评价显示血气胸和休克。在采取初步稳定措施后,由于心包积血,患者被紧急转移到我们的机构,最初怀疑是继发于外伤性主动脉夹层。然而,入院心电图清楚地显示并发前壁和高侧壁心肌梗死。冠状动脉造影显示左前降支闭塞。我们尝试对LAD进行介入治疗以恢复血流。然而,术中发现LAD完全破裂。患者被转移到心脏外科进行紧急冠状动脉搭桥术(CABG)。异物成功取出,CABG完成,无并发症。患者在短期ECMO支持下逐渐恢复,顺利出院。后续评估显示复苏情况良好。讨论:外伤性心肌梗死的发病机制复杂多变。鉴于急诊医生和心脏病专家在这类病例中往往缺乏丰富的经验,他们应该谨慎行事,进行彻底的评估,并精心规划诊断和治疗的每一步。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rescue of acute ST-elevation myocardial infarction secondary to traumatic coronary artery rupture: a case report.

Background: Trauma-related acute myocardial infarction represents a complex and high-risk condition in the emergency department, necessitating a range of sophisticated treatment strategies. Failure to provide timely and accurate intervention significantly increases the risk of short-term mortality.

Case summary: We present the case of a 36-year-old male who was admitted to local hospital following a penetrating chest trauma. Relevant diagnostic evaluations revealed haemopneumothorax and shock. Following initial stabilization measures, the patient was urgently transferred to our institution due to haemopericardium, which was initially suspected to be secondary to traumatic aortic dissection. However, the admission electrocardiogram clearly demonstrated concurrent anterior and high lateral wall myocardial infarction. Coronary angiography revealed occlusion of the left anterior descending (LAD) artery. We attempted interventional therapy on the LAD to restore blood flow. However, intraoperative findings revealed complete rupture of the LAD. The patient was transferred to the cardiac surgery department for emergency coronary artery bypass grafting (CABG). The foreign body was successfully retrieved, and the CABG was completed without complications. The patient gradually recovered under short-term ECMO support and was discharged successfully. Follow-up assessments indicate a favourable recovery.

Discussion: The mechanism underlying traumatic myocardial infarction is complex and variable. Given that emergency physicians and cardiologists often lack extensive experience in such cases, they should exercise caution, conduct a thorough assessment, and meticulously plan each step of diagnosis and treatment.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
European Heart Journal: Case Reports
European Heart Journal: Case Reports Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.30
自引率
10.00%
发文量
451
审稿时长
14 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信