Hiten Patel1*, Yamini Sundermurthy1, Suchit Bhutani2 and Mahesh Bikkina1
1Department of Internal Medicine, Division of Cardiology, New York Medical College, Saint Joseph’s Regional Medical Center, Paterson, New Jersey, USA
2Department of Internal Medicine, Abington Hospital – Jefferson health, Philadelphia, USA
Received: 05 May, 2017; Accepted: 15 June, 2017; Published: 16 June, 2017
Hiten R Patel, MD, Cardiology fellow, New York Medical College, Saint Joseph’s Regional Medical Center, 703 Main St, Paterson, New Jersey 07503, USA, Tel: (917) 627-1437; (973) 754-2028; Fax: (973) 754-4349; E-mail:
Patel H, Sundermurthy Y, Bhutani S, Bikkina M (2017) A rare case of Contusio Cordis: Fist fight leading to an Acute Myocardial Infarction due to Left Anterior Descending artery dissection. J Cardiovasc Med Cardiol 4(2): 026-028. 10.17352/2455-2976.000045
© 2017 Patel H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Cardiac lesions resulting from blunt chest injuries can present as cardiac contusion; ventricular free wall rupture; ventricular septal rupture; and valvular lesion . But acute Myocardial infarction (MI) from contusio cordis is a very rare complication. Here we present a case of fist punch to the chest leading to distal Left Anterior Descending (LAD) artery dissection causing acute MI.
A 28 year old Hispanic male with history of alcohol abuse presented to our hospital with chest pain that started 7 hours prior to arrival after he sustained a fist punch to the chest during an altercation at a bar. It was associated with shortness of breath and palpitations. He tried ibuprofen with no relief. Vital signs were stable. Physical exam revealed ecchymosis of the mid sternal region with chest wall tenderness. ECG showed normal sinus rhythm and ST segment elevations in anterior and inferior leads (Figure 1). Troponin-I was elevated at 0.32 ng/ml. 2D ECHO showed normal left ventricular ejection fraction with no regional wall motion abnormality, no effusion or acute valvular pathology. Patient’s chest pain improved with sublingual nitroglycerine; however, 2nd set of Troponin-I was 14.12 ng/ml, so he underwent coronary angiography that showed dissection of distal LAD with thrombus (Figure 2). Owning to small caliber vessel, patient was managed conservatively with aspirin, clopidogrel, atorvastatin and eptifibatide. Heparin drip, which was started prior to angiography, was discontinued and eptifibatide was given for 18hrs. He made good recovery and was discharged on aspirin and clopidogrel with a follow up in 6 weeks.
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