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

Abu-Hmeidan, Jareer Heider; Arrowaili, Arief Ismael; Yousef, Raid Said; Alasmari, Sami; Kassim, Yasser M; Aldakhil Allah, Hamad Hamad; Aljenaidel, Abdullah Mohammed; Alabdulqader, Abdullah Abdulmohsen; Alrashed, Muath Hamad; Alkhinjar, Mulfi Ibrahim; Al-Shammari, Nawwaf Rahi

doi:10.1186/s13019-016-0528-6

Journal of Cardiothoracic Surgery

Table 1 Summary of reported cases of coronary artery rupture in blunt thoracic trauma

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

Reference	Age & gender	Mechanism of injury	Diagnosis	Presentation	Artery involved	Associated cardiac injuries	Pericardial defect	Coronary artery disease	Management	Time window^a	Outcome
Goffin et al. 1974 [11].	62 M	MVC	Autopsy	Dyspnea, chest pain, shock. CXR: Multiple rib fractures. Slight enlargement of the heart. ECG changes of inf. MI and AV block. Moderately elevated CPK and SGOT.	RCA	Aortic tear. Intimal tear in LCX	Present	Present	Pericardiocentesis (failed)	9.5 h	Died
Trotter et al. 1998 [9].	15 M	MVC	Intraop.	Chest wall contusion. Continuous murmur. Initially stable vital signs, then worsening dyspnea and cardiogenic shock. CXR: widened cardiac silhouette. RBB on ECG.	RCA	Tricuspid valve	Present	N/A^b	ACB	8 h	Survived
Suzuki et al. 2000 [6].	59 M	FD	Autopsy	Severe dyspnea and chest pain 14 h after the incident. CXR: fractures of left 7th and 8th ribs with left pleural effusion.	LAD	None	Present	N/A^b	None	17 h	Died
Dimopoulos et al. 2003 [16].	78 F	FD	Autopsy	Anemia. Massive left pleural effusion on CXR. Atrial fibrillation and LBBB. Echocardiogram: 700 ml of pericardial effusion with normal ejection fraction.	ICA	None	N/A^b	N/A^b	None	N/A	Died
Straub et al. 2003 [10].	71 M	FD	Intraop.	No visible chest wall lesions. Cardiogenic shock. CXR: normal. Elevated cardiac enzymes. Echocardiography: pericardial effusion, no wall motion disturbances. CT scan: hemorrhagic pericardial effusion and para-aortic contrast fluid extravasation.	RCA	None	None	Present	OPCAB	14 h	Died
Sugimoto et al. 2003 [17].	34 M	MVC	Intraop.	Unconscious and in severe shock. Echocardiogram: massive hemopericardium.	RCA	None	N/A^b	N/A^b	ER thoracotomy with attempted ligation of the RCA. Interval ACB three weeks later.	No delay	Survived
Dueholm et al. 2009 [12].	44 M	MVC	Autopsy	Chest pain. Normal exam. ECG: Acute MI. CXR: Fractures in left 6th and 7th ribs. Arrhythmia, followed by cardiogenic shock.	RCA	None	N/A^b	Present	None.	56 h	Died
Tyson et al. 2010 [7].	69 M	MVC	Intraop.	Breath sounds decreased on the left. CXR: left hemothorax and widened mediastinum. CT scan: minimal pericardial fluid. Fractures in left 2nd -7th ribs. Tube thoracostomy drained 2 L of blood.	OM	Posterior cardiac vein	Present	N/A^b	Anterolateral thoracotomy and ligation of bleeding vessels.	2 h	Survived
Burcar et al. 2013 [18].	15 M	MVC	Intraop.	Chest wall hematomas. GCS 5/15. Hypotension. ST segment depression. Troponin I & CPK elevation. Bilateral lung contusions on CT scan.	LM	Intimal tear in MPA	N/A^b	N/A^b	Sternotomy. Pericardiotomy. LIMA to LAD. SVG to LCX.	N/A	Died

MVC motor vehicle collision, FD falling down, LAD left anterior descending artery, RCA right coronary artery, LCX circumflex artery, ICM intermediate coronary artery, OM obtuse marginal artery, LM left main coronary artery, MPA main pulmonary artery, ACB aortocoronary bypass, OPCAB off pump coronary artery bypass, LIMA left internal mammary artery, SVG saphenous vein graft
^aTime window between injury and intervention or death
^bNo explicit information about the finding was provided in the case report

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