ST-elevation Myocardial Infarction Indirectly Induced by Trauma

Abstract

Myocardial infarction (MI) can be provoked by various conditions including blunt chest trauma or stress. We herein report a case of traumatic pneumothorax of the right side in which ST-segment elevation MI developed later, probably due to stress after trauma. A 63-year-old man presented with chest pain after trauma. Pneumothorax of the right chest accompanied by an 8th right rib fracture was confirmed on chest computed tomography. Although electrocardiography was considered nonspecific on presentation, at 40 minutes after presentation, prominent ST-segment elevation in the precordial and lateral leads were noted. A diagnosis of anterior acute MI was made. Emergency coronary angiography, performed after the insertion of a chest tube into the right chest cavity, revealed total occlusion of the left anterior descending coronary artery. Coronary recanalization was obtained by thrombus aspiration and stent implantation. The clinical course was uneventful. The present case highlights the importance of recognizing trauma not only as a direct trigger but also as an indirect trigger of acute MI.