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Obstruction of the Proximal Right Coronary Artery with Acute Inferior Infarction Due to Blunt Chest Trauma

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▸Requests for reprints should be addressed to Philip B. Oliva, M.D.; Division of Cardiology, Denver General Hospital; Denver, CO 80204.

Denver Colorado

© 1979 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1979;91(2):205-207. doi:10.7326/0003-4819-91-2-205
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Two patients developed an acute transmural myocardial infarction due to severe obstruction of the proximal right coronary artery after blunt chest trauma. Neither had a history of ischemic heart disease, and both had an arteriographically normal left coronary artery. In one patient significant resolution of the subtotal obstruction occurred within 3 months. An intimal tear or subintimal hemorrhage with luminal thrombosis, or both, are the suggested mechanism of coronary arterial occlusion. Spasm and platelet aggregates may contribute. Despite a large number of automobile accidents, obstruction of the right coronary artery due to blunt chest trauma has not been previously described. This suggests it has been overlooked and should be especially suspected in persons with injury to the sternum and an acute inferior myocardial infarction.





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