Delayed diagnosis of myocardial infarction in a young man with a blunt chest trauma

Abstract

A 19 year old man was admitted to emergency department (ED) because of motorcycle to motorcycle accident. In ED he was evaluated as a multiple trauma patient and after overnight observation, was discharged with stable vital signs (VS) next morning. Twenty four hours later, he developed chest pain and dyspnea, and was admitted to ED for the second time. This time he was evaluated as a chest trauma patient and chest X ray and CT scanning were performed. According to cardiology consult, an electrocardiogram was recorded and extensive anterolateral ST elevation myocardial infarction (STEMI) was confirmed. Coronary angiography revealed total thrombotic occlusion of left anterior descending artery (LAD) from ostium. Percutaneous coronary intervention (PCI) was performed and LAD stented successfully. After 10 days of ICU admission, he was discharged with an ejection fraction (EF) of 35%.