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J Thorac Cardiovasc Surg 2007;133:811-812
© 2007 The American Association for Thoracic Surgery

Brief Communication

Left anterior descending coronary artery dissection after blunt chest trauma: Assessment by multi-detector row computed tomography

Tarek Smayra, MDa,*, Roger Noun, MDb, Carla Tohmé-Noun, MDa

a Radiology Department, Hotel-Dieu hospital, Beirut, Lebanon
b Surgery Department, Hotel-Dieu hospital, Beirut, Lebanon.

Received for publication November 13, 2006; accepted for publication November 20, 2006.

* Address for reprints: Tarek Smayra, MD, Radiology Department, Hotel-Dieu hospital, Adib Ishak str, 16-6830, Beirut, Lebanon. (Email: tarek.smayra@hdf.usj.edu.lb; tarek_smayra@hotmail.com).

The first 20% of the full text of this article appears below.

A 17-year-old male patient with no previous heart disease was sent to our institution for multi-detector row computed tomography (MDCT) coronary angiography following posttraumatic myocardial infarction.

Clinical Summary

Two months earlier, this unrestrained driver had an accident and sustained steering wheel injury as well as head trauma and multiple fractures. He was admitted to the intensive care unit for loss of consciousness at the scene and had his fractures repaired. Follow-up was unremarkable and he was discharged 1 month after the accident. A few days later, he presented with chest pain associated with ST elevation in the precordial leads on electrocardiogram and high serum level of creatine kinase with a positive MB fraction. Transthoracic echocardiography showed moderate hypokinesis of the septum and the anterior wall. MDCT coronary angiography was carried out using a 64-slice LightSpeed VCT (General Electric Healthcare, Little Chalfont, UK) with 0.625-mm collimation, cardiac gating, and intravenous injection of iopromide 370 mg (milligrams of iodine)/mL (Ultravist, Schering AG, Germany). It showed . . . [Full Text of this Article]




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