Abstract
A 30-year-old man was kicked in the chest during a fight and developed chest pain. He presented to the hospital the same day, but it was thought that the pain was due to a broken rib and he was discharged with nonsteroidal antiinflammatory drugs. The pain was intermittent and continued; after three days he was referred to our hospital for a possible cardiac source of the pain. An electrocardiogram showed extensive anteroseptal myocardial infarction, and ST segment was elevated in leads V1 to V6. Cardiac enzymes were elevated. Echocardiography demonstrated akinesia in all left anterior descending artery territory. The patient underwent angiography, which demonstrated that the left anterior descending artery was totally occluded at the proximal portion. The other coronary arteries were completely normal (Figs 1 and 2). A stent was placed in the left anterior descending artery, and the blood flow was restored (Fig 3). After 3 months, the patient developed ischemic cardiomyopathy. He had a left ventricle ejection fraction of 15 and right ventricle ejection fraction of 15. He is being treated medically for heart failure. Fig 1.
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