Infarto agudo del miocardio debido a trauma cerrado de tórax Acute mioicardial infarction due to chest blunt trauma

This is a case of the 43 year old male patient without history or risk factors for coronary disease, with blunt trauma in the chest anterior region with a ball and right after he had the typical chest pain; at the emergency room he had the diagnosis made of an acute coronary event with elevation of the ST segment in the anterior septal side; the echocardiogram showed segmental upheavals of contractility without evidence of flin the pericardium. Fibrinolysis with streptokinase showed improvement, pain disappeared and ST was normal in the electrocardiogram. A spasm was found in the anterior descending artery that improved with intracoronary nitroglycerine, and critical stenosis in 95% in the circumfl ex. We report this case because it is not frequent it has psychopathological aspects and highlights coronariography and angioplasty as diagnosis and treatment patterns. (Acta Med Colomb 2007; 32: 93-96)