4.2 Article

Spontaneous Resolution of an Accidental Total Coronary Occlusion

Journal

INTERNAL MEDICINE
Volume 49, Issue 23, Pages 2593-2597

Publisher

JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.49.4286

Keywords

STEMI; blunt chest trauma; CT scanning

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In December 2007, a woman was involved in a traffic accident. At first, her vital signs were normal, but electrocardiogram showed ST-segment elevation in the inferior leads. She was diagnosed as a blunt chest trauma-induced myocardial infarction. Her right coronary angiography showed total occlusion. She underwent an emergency coronary artery bypass surgery; 64-multi-detector-row computed tomography (64-MDCT) demonstrated an intravascular protruding lesion, which suggested subintimal hematoma. One month later, repeat coronary angiogram showed spontaneous recanalization, and 64-MDCT showed no discontinuous vessel wall. Coronary artery occlusion secondary to blunt chest trauma is rare, and it's even rarer to have spontaneous recanalization.

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