Coronary Artery Dissection and Myocardial Infarction Due to Blunt Chest Trauma

Introduction: Coronary artery dissection and myocardial infarction happen rarely after BCT (3). In the following, a rare case of acute myocardial infarction (AMI) caused by the dissection of left anterior descending (LAD) artery following BCT due to suffering a blow in boxing is presented.

Case presentation: A 22-year-old professional boxing athlete presented with chest pain and dyspnea from a week ago to our center. A week before the visit, the patient referred to the general hospital complaining from chest pain and nausea after suffering a blow during boxing. According to the ECG and normal cardiac troponin, the patient was discharged with diagnosis of Prinzmetal Angina (without coronary angiography). When referring our center, lead electrocardiogram (ECG)  was done and showed ST segment elevation on V1-V4 leads and T inversion on aVL and I leads. According to wchocardiography, (LVEF) was calculated to be 45%. Angiography was performed due to the lack of definitive diagnosis and suspicion of coronary artery disease. Results of angiography showed coronary artery dissection on LAD. Finally, the patient was diagnosed with AMI due to LAD dissection and was subjected to angioplasty intervention

Discussion: In our case, BCT resulted in LAD dissection after a less common cause of trauma. Not having a serious risk factor, the presence of atypical symptoms of the disease, as well as evidence of ST segment elevation without increasing the cardiac enzyme led to dilemma and delayed diagnosis, and the diagnosis of Prinzmetal angina was mistaken for the patient. So due to failure of improvement and further investigation, the diagnosis of AMI due to LAD dissection after BCT reached certainty