Chest pain in a young basketball player

Research output: Contribution to journalArticle

Abstract

A 32-year-old man was elbowed in the chest while fighting for a rebound in a recreational basketball game. He fell to the ground and his chest ached from the blow. Four days later he developed more severe chest pressure with dyspnea and came to the hospital. His chest wall was tender and his pulse slow, but the remainder of his physical examination was normal. Electrocardiogram showed sinus bradycardia, first-degree atrioventricular (AV) block, and occasional isorhythmic AV dissociation, but no ischemic ST-T changes. Cardiac troponin I rose to 1.74 ng/mL (normal <0.50). The patient therefore underwent coronary angiography, showing spiral dissection of the right coronary artery with extensive thrombus filling the distal portion of the vessel. Stenting was unsuccessful in restoring flow. This case highlights the potential dangers of blunt chest trauma in recreational sports and shows how angiography can distinguish myocardial contusion from coronary artery dissection.

Original languageEnglish (US)
Pages (from-to)C7-C10
JournalJournal of general internal medicine
Volume21
Issue number6
DOIs
StatePublished - Jun 1 2006

Keywords

  • Blunt cardiac trauma
  • Blunt chest trauma
  • Coronary artery dissection
  • Coronary artery injury

ASJC Scopus subject areas

  • Internal Medicine

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