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Blunt traumatic right coronary artery dissection presenting with second-degree atrioventricular block and late-onset severe cardiogenic shock

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Blunt traumatic right coronary artery dissection presenting with second-degree atrioventricular block and late-onset severe cardiogenic shock. / Paparoupa, Maria; Conradi, Lenard; Warncke, Malte Lennart; Well, Lennart; Burdelski, Christoph; Cramer, Christopher; Grahn, Hanno; Kubik, Mathias; Kluge, Stefan.

In: BMC CARDIOVASC DISOR, Vol. 22, No. 1, 341, 30.07.2022.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Paparoupa, M, Conradi, L, Warncke, ML, Well, L, Burdelski, C, Cramer, C, Grahn, H, Kubik, M & Kluge, S 2022, 'Blunt traumatic right coronary artery dissection presenting with second-degree atrioventricular block and late-onset severe cardiogenic shock', BMC CARDIOVASC DISOR, vol. 22, no. 1, 341. https://doi.org/10.1186/s12872-022-02784-6

APA

Paparoupa, M., Conradi, L., Warncke, M. L., Well, L., Burdelski, C., Cramer, C., Grahn, H., Kubik, M., & Kluge, S. (2022). Blunt traumatic right coronary artery dissection presenting with second-degree atrioventricular block and late-onset severe cardiogenic shock. BMC CARDIOVASC DISOR, 22(1), [341]. https://doi.org/10.1186/s12872-022-02784-6

Vancouver

Paparoupa M, Conradi L, Warncke ML, Well L, Burdelski C, Cramer C et al. Blunt traumatic right coronary artery dissection presenting with second-degree atrioventricular block and late-onset severe cardiogenic shock. BMC CARDIOVASC DISOR. 2022 Jul 30;22(1). 341. https://doi.org/10.1186/s12872-022-02784-6

Bibtex

@article{26d26546552847b19431c139b1b1d045,
title = "Blunt traumatic right coronary artery dissection presenting with second-degree atrioventricular block and late-onset severe cardiogenic shock",
abstract = "BACKGROUND: Blunt chest injury may induce several cardiovascular traumata, requiring immediate care. Right coronary artery dissection (RCA) is an extremely rare sequela in this setting and is associated with high mortality, if it remains undiagnosed. Case presentation We present the case of an RCA dissection after blunt chest trauma in a 16-year-old patient, who initially presented with a second-degree atrioventricular block as solitary manifestation on admission. Typical electrocardiographic findings, such as ST segmental changes or pathological Q waves were absent. Serial echocardiograms excluded segmental motion abnormalities, pericardial effusion or right ventricular strain. Nevertheless, a complementary computed tomography coronary angiography revealed this potentially lethal condition several hours later. The patient underwent an emergency surgical myocardial revascularization under the circulatory support of veno-arterial extracorporeal membrane oxygenation and suffered a prolonged right ventricular insufficiency with severe late-onset cardiogenic shock, due to an extensive myocardial infarction of the inferoseptal ventricular wall.CONCLUSION: Right coronary artery dissection after high-speed blunt chest injury constitutes a diagnostic challenge, especially in the absence of typical electrocardiographic and echocardiographic findings in young patients. This condition may dramatically deteriorate in time, leading to severe cardiogenic shock and life-threatening arrhythmias.",
keywords = "Adolescent, Aneurysm, Dissecting/complications, Atrioventricular Block/diagnosis, Coronary Vessels/diagnostic imaging, Humans, Shock, Cardiogenic/diagnosis, Thoracic Injuries/complications, Wounds, Nonpenetrating/complications",
author = "Maria Paparoupa and Lenard Conradi and Warncke, {Malte Lennart} and Lennart Well and Christoph Burdelski and Christopher Cramer and Hanno Grahn and Mathias Kubik and Stefan Kluge",
note = "{\textcopyright} 2022. The Author(s).",
year = "2022",
month = jul,
day = "30",
doi = "10.1186/s12872-022-02784-6",
language = "English",
volume = "22",
journal = "BMC CARDIOVASC DISOR",
issn = "1471-2261",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Blunt traumatic right coronary artery dissection presenting with second-degree atrioventricular block and late-onset severe cardiogenic shock

AU - Paparoupa, Maria

AU - Conradi, Lenard

AU - Warncke, Malte Lennart

AU - Well, Lennart

AU - Burdelski, Christoph

AU - Cramer, Christopher

AU - Grahn, Hanno

AU - Kubik, Mathias

AU - Kluge, Stefan

N1 - © 2022. The Author(s).

PY - 2022/7/30

Y1 - 2022/7/30

N2 - BACKGROUND: Blunt chest injury may induce several cardiovascular traumata, requiring immediate care. Right coronary artery dissection (RCA) is an extremely rare sequela in this setting and is associated with high mortality, if it remains undiagnosed. Case presentation We present the case of an RCA dissection after blunt chest trauma in a 16-year-old patient, who initially presented with a second-degree atrioventricular block as solitary manifestation on admission. Typical electrocardiographic findings, such as ST segmental changes or pathological Q waves were absent. Serial echocardiograms excluded segmental motion abnormalities, pericardial effusion or right ventricular strain. Nevertheless, a complementary computed tomography coronary angiography revealed this potentially lethal condition several hours later. The patient underwent an emergency surgical myocardial revascularization under the circulatory support of veno-arterial extracorporeal membrane oxygenation and suffered a prolonged right ventricular insufficiency with severe late-onset cardiogenic shock, due to an extensive myocardial infarction of the inferoseptal ventricular wall.CONCLUSION: Right coronary artery dissection after high-speed blunt chest injury constitutes a diagnostic challenge, especially in the absence of typical electrocardiographic and echocardiographic findings in young patients. This condition may dramatically deteriorate in time, leading to severe cardiogenic shock and life-threatening arrhythmias.

AB - BACKGROUND: Blunt chest injury may induce several cardiovascular traumata, requiring immediate care. Right coronary artery dissection (RCA) is an extremely rare sequela in this setting and is associated with high mortality, if it remains undiagnosed. Case presentation We present the case of an RCA dissection after blunt chest trauma in a 16-year-old patient, who initially presented with a second-degree atrioventricular block as solitary manifestation on admission. Typical electrocardiographic findings, such as ST segmental changes or pathological Q waves were absent. Serial echocardiograms excluded segmental motion abnormalities, pericardial effusion or right ventricular strain. Nevertheless, a complementary computed tomography coronary angiography revealed this potentially lethal condition several hours later. The patient underwent an emergency surgical myocardial revascularization under the circulatory support of veno-arterial extracorporeal membrane oxygenation and suffered a prolonged right ventricular insufficiency with severe late-onset cardiogenic shock, due to an extensive myocardial infarction of the inferoseptal ventricular wall.CONCLUSION: Right coronary artery dissection after high-speed blunt chest injury constitutes a diagnostic challenge, especially in the absence of typical electrocardiographic and echocardiographic findings in young patients. This condition may dramatically deteriorate in time, leading to severe cardiogenic shock and life-threatening arrhythmias.

KW - Adolescent

KW - Aneurysm, Dissecting/complications

KW - Atrioventricular Block/diagnosis

KW - Coronary Vessels/diagnostic imaging

KW - Humans

KW - Shock, Cardiogenic/diagnosis

KW - Thoracic Injuries/complications

KW - Wounds, Nonpenetrating/complications

U2 - 10.1186/s12872-022-02784-6

DO - 10.1186/s12872-022-02784-6

M3 - SCORING: Journal article

C2 - 35906536

VL - 22

JO - BMC CARDIOVASC DISOR

JF - BMC CARDIOVASC DISOR

SN - 1471-2261

IS - 1

M1 - 341

ER -