Case 3: A 51-Year-Old Man with Blunt Injury to the Anterior Chest
A 51-year-old man was repairing a truck when he was hit in his anterior chest by a malfunctioning air bag. Shortly afterwards he developed very severe chest pain and an ambulance was called. He is brought to the emergency department where this ECG was recorded:
- Sinus rhythm, 65/min.
- Right bundle branch block
- Acute Anterolateral Infarction
The patient was immediately transferred to the cardiac catheterization lab. The proximal LAD coronary artery was totally occluded. A thrombus was removed and flow was restored. Intra-vascular ultrasound demonstrated dissection in the proximal LAD. There was also a small dissection in the proximal main left coronary artery that, however, was non flow-limiting. The proximal and middle segment of the LAD was therefore balloon-dilated and stented. The patient’s chest pain markedly improved and he was transferred to the cardiac surgical ICU. His condition remained satisfactory and stable. ECG#2 was recorded 12 hours later:
- Sinus rhythm, 67/min
- Septal myocardial infarction
ECG ID: E744