It is estimated that 15% of
traffic accidents cause
trauma to large vessels. In about 70%-95% of cases,
aortic rupture took place in the distal
ligament of the left
subclavian artery, whereas in the remaining cases
rupture occurred in the
ascending aorta above the
aortic valve.
Trauma to the
aortic sinus and
coronary arteries is rarely found in
traffic accident victims. Therefore,
coronary artery trauma is often misdiagnosed as coronary atherosclerotic
heart disease. The present case is a 42 years old
male who survived from a
traffic accident. He presented with
aortic sinus and left
coronary artery trauma. He was misdiagnosed as having coronary atherosclerotic
heart disease, and therefore wrongly given antiplatelet
medicine, such as
aspirin, in another
hospital. Definite
diagnosis was achieved in our
hospital, and the
patient underwent Bentall and
mitral valve replacement, as well as tricuspid valvuloplasty. The aortic occlusion
time during
surgery was 47 min, and the total
cardiopulmonary bypass time was 63 min. After
surgery,
transthoracic echocardiography confirmed that all the artificial valves worked sufficiently. The
patient felt good and symptoms such as
asthma and decreased
exercise tolerance disappeared. This case taught us that
acute aortic syndrome cannot be ignored when
patients present with pectoralgia; antiplatelet medication should not be given before definite
diagnosis.