Revista medica del Instituto Mexicano del Seguro Social · 2010
[Chest blunt trauma associated with myocardial infarction. Case report].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Díaz-Méndez Macrina, Vázquez-Cortés Jorge Arturo, Flores-Arenas Juan Ricardo, Rábago-Escoto Ruth del Carmen
Аннотация
BACKGROUND: Blunt chest trauma has become a major health problem in the emergency room due to the increase in the number of traffic accidents. The cardiac contusion is sufficient entity to cause cellular damage and enzymatic electric effects.
CLINICAL CASE: 58 years old male, presented with chest pain secondary to direct trauma with irradiation to left arm, accompanied by diaphoresis and dyspnea which last 2 hours. Cardiac enzymes serum levels were: CK 2017 CPKMB 381, DHL 823, AST 182; electrocardiogram reported: extensive ischemia with extensive anterior subepicardial injury.
CONCLUSIONS: The patient presented without risk factors for coronary disease. The possible mechanism of injury was vasospasm despite the failure to timely perform a coronary angiography which is recommended in these cases. Tests such as the electrocardiogram, measurement of isoenzymes of creatinine phosphokinase-MB levels and echocardiography can be useful and should be performed in all patients with suspected cardiac injury. Treatment modalities include percutaneous coronary intervention and coronary artery bypass surgery.
CLINICAL CASE: 58 years old male, presented with chest pain secondary to direct trauma with irradiation to left arm, accompanied by diaphoresis and dyspnea which last 2 hours. Cardiac enzymes serum levels were: CK 2017 CPKMB 381, DHL 823, AST 182; electrocardiogram reported: extensive ischemia with extensive anterior subepicardial injury.
CONCLUSIONS: The patient presented without risk factors for coronary disease. The possible mechanism of injury was vasospasm despite the failure to timely perform a coronary angiography which is recommended in these cases. Tests such as the electrocardiogram, measurement of isoenzymes of creatinine phosphokinase-MB levels and echocardiography can be useful and should be performed in all patients with suspected cardiac injury. Treatment modalities include percutaneous coronary intervention and coronary artery bypass surgery.