A Case of Coronary Artery Dissection after Blunt Chest Trauma Resulting in ST-Segment Elevation Myocardial Infarction / 대한내과학회지

Coronary artery injury after thoracic injury is very rare, but can result in serious acute myocardial infarction (MI). It can be easily mistaken for chest wall pain or cardiac contusion if relying solely on a history and physical examination. We herein report a rare case of a 60-year-old female patient who presented with inferior wall ST-segment elevation MI due to right coronary artery dissection following blunt chest trauma after a traffic accident. Successful primary percutaneous coronary intervention was performed without complications.

A Case of Myocardial Bridge in a Patient with Hypertrophic Cardiomyopathy

Although myocardial bridge is not thought to have any hemodynamic significance in most cases, some have suggested that when it produces severe systolic narrowing, ischemia or infarction may result. Myocardial bridge in adults with hypertrophic cardiomyopathy may be associated with a higher incidence of sudden death, myocardial wall-motion abnormalities, and perfusion defects on thallium-201 scintigraphy. When myocardial bridge is associated with left ventricular hypertrophy, it is known to affect longer segment and cause more severe compression during systole. We report a case of hypertrophic cardiomyopathy with myocardial bridge at the middle part of the left anterior descending coronary artery, who also showed reversible perfusion defect on the thallium scan at the same coronary territory.

Massive Gastrointestinal Bleeding Following Intracranial Lesion

"Stress ulceration" of the stomach and duodenum is a nonspecific term used to cover a wide variety of different entities. It has been known for many years that there is an association between gastrointestinal bleeding and intracranial lesion. This is not a common clinical problem, but it has been noted to be increasing over the recent years, possibly due to the increased survival of severe injured neurosurgical patients and neurosurgical procedures. Clinically recongnition of gastrointestinal bleeding or ulceration can be difficult, partcularly in the unconscious patient and prevention of this complication has not been successful. The treatment of that has been the subject of considerable controversy. Prognosis depends on a prevention of hemorrhagic shock or sepsis and promptly proper management. The authors analyzed the 21 cases of massive gastrointestinal bleeding in neurosurgical patients, who were admitted to the department of neurosurgery of National Medical Center from 1978 to 1980.