[Traumatic infarction following stab wound of the heart (author's transl)].

Case report about a myocardial infarction following stab wound of the left atrium including a complete severance of the left coronary artery: An athletic 35-year-old man suffered a latero-medial stab wound of the thorax. The knife had penetrated the left lung and the atrium of the hypertrophic left heart. Postoperatively, the patient developed a heart infarction; 40 h after trauma he died. The postmortem revealed traumatic necrosis of the left atrium, an intraoperatively undiscovered complete severance of the ramus circumflexus arteriae coronariae sinistrae and an antero-lateral ischemic cardionecrosis of the left ventricle. The location of the infarction could be explained by an extreme right preponderance of the coronary blood supply. Traumatic and ischemic myocardial necrosis differed distinctly in the amount of contraction bands. Other causes for such morphological changes like catecholamine-cardiomyopathy (so-called epinephrine myocarditis) or heart operations are discussed.