Journal of Emergencies, Trauma, and Shock
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Year : 2018  |  Volume : 11  |  Issue : 3  |  Page : 230-232

Fatal acute myocardial infarction after multiple blunt injuries involving the chest

Acute Critical Care and Emergency Medicine, Shizuoka Hospital, Juntendo University Address 1129 Nagaoka, Izunokuni-city, Shizuoka 410-2295, Japan

Correspondence Address:
Prof. Youichi Yanagawa
1129 Nagaoka, Izunokuni-city City, Shizuoka 410-2295
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JETS.JETS_39_18

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The patient was a 60-year-old male fell whose head and left chest hit the ground after falling from a height of 2 m. He complained of the left shoulder and chest pain after regaining consciousness. On arrival, he showed left bloody otorrhea, left chest tenderness, and a limited range of motion due to the left shoulder pain. Emergency chest roentgenography revealed multiple left rib fractures, left clavicular fracture with decreased radiolucency in the left lung field, suggesting lung contusion. When the patient was being transported for computed tomography, he suddenly displayed ventricular tachycardia with pulse and subsequently became VF storm, which required percutaneous cardiopulmonary support. The coronary angiogram showed complete obstruction of the branch of the anterior descending artery. Coronary angioplasty resulted in recanalization; however, massive hemorrhage from the left ear was recognized. Computed tomography revealed traumatic subarachnoid hemorrhage and left massive hemothorax requiring thoracostomy. Massive hemorrhage from the left ear and left thoracic cavity continued after the patient was transported to the coronary care unit. He underwent massive transfusion; however, he died on the same day.

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