Traumatic dissection of a coronary artery: detection by multislice computed tomography and use of tirofiban as a reversible platelet inhibitor.

Abstract

We report on a trauma victim without history of or risk factors for cardiac disease, who suffered coronary artery dissection caused by blunt chest injury (BCI). Myocardial ischaemia was detected by multislice computed tomography (MSCT) promptly after trauma centre admission and managed by immediate revascularisation. Thoracic trauma may cause myocardial ischaemia in the absence of a specific risk profile. MSCT, as part of initial work-up in severely injured patients, may support differential diagnosis after BCI. Tirofiban and unfractionated heparin as short-acting anticoagulants warrant stent patency and concurrently offer the possibility of quick recovery of haemostasis in case of haemorrhage.