Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back
We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and h...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic and Cardiovascular Surgery
2015-08-01
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| Series: | Korean Journal of Thoracic and Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.kjtcvs.org/journal/download_pdf.php?doi=10.5090/kjtcs.2015.48.4.281 |
| Summary: | We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue
following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1,
aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic
shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left
main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was
then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient
was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery
intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up,
her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical
support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive
cardiopulmonary resuscitation, she died. |
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| ISSN: | 2233-601X 2093-6516 |