Primary Stenting for Traumatic Coronary Artery Dissection Resulting from Blunt Chest Trauma—A Case Report

Traumatic coronary artery dissection is an extremely uncommon cause of myocardial infarction. We report a case of spontaneous coronary artery dissection in an 18-year-old previously healthy male caused by myocardial contusion. He was admitted to the hospital with a history of chest trauma and fracture of the radius and ulna bilaterally resulting from a motorcycle accident. The electrocardiograms, elevated creatine kinase, and cardiac troponins revealed acute anterior myocardial infarction. The transthoracic echocardiogram showed significant segmental wall motion abnormalities and moderate left ventricular systolic dysfunction. The coronary angiogram showed a traumatic dissection involving the proximal left anterior descending coronary artery. He underwent a dobutamine echocardiography “viability study” that revealed significant viable myocardium involving 50% of the left anterior descending coronary artery territory. He was treated by primary stent implantation (Cypher and regular stents) with an excellent result.