Skip to main content
SpringerLink
Log in

Chest pain in a young basketball player

  • Case Report
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Parmley LF, Manion WC, Mattingly TW. Nonpenetrating traumatic injury of the heart. Circulation. 1958;18:371–96.

    Article  CAS  Google Scholar 

  2. Salehian O, Teoh K, Mulji A. Blunt and penetrating cardiac trauma: a review. Can J Cardiol. 2003;19:1054–9.

    Google Scholar 

  3. Vlay SC, Blumenthal DS, Shoback D, Fehir K, Bulkley BH. Delayed acute myocardial-infarction after blunt chest trauma in a young woman. Am Heart J. 1980;100:907–16.

    Article  CAS  Google Scholar 

  4. Greenberg J, Salinger M, Weschler F, Edelman B, Williams R. Circumflex coronary artery dissection following waterskiing. Chest. 1998;113:1138–40.

    Article  CAS  Google Scholar 

  5. Gustavsson CG, Albrechtsson U, Forslind K, Stahl E, White T. A case of right coronary artery occlusion, caused by blunt chest trauma and treated with acute coronary artery bypass surgery. Eur Heart J. 1992;13:133–6.

    Article  CAS  Google Scholar 

  6. Moore JE. Acute apical myocardial infarction after blunt chest trauma incurred during a basketball game. J Am Board Fam Pract. 2001;14:219–22.

    CAS  Google Scholar 

  7. Dahle TG, Berger A, Tuna N, Das G. Coronary artery stenting for acute myocardial infarction secondary to mild, blunt chest trauma in a soccer player. J Invasive Cardiol. 2005;17:163–4.

    Google Scholar 

  8. Vasudevan AR, Kabinoff GS, Keltz TN, Gitler Blunt chest trauma producing acute myocardial infarction in a rugby player. Lancet. 2003;362:370.

    Article  Google Scholar 

  9. Kwon OY, Chung SP, Yoo IS, Song CJ, Kim IB, Kim SW. Delayed presentation of internal mammary artery rupture after blunt chest trauma: characteristic CT and plain X ray findings. Emerg Med J. 2005;22:664–5.

    Article  CAS  Google Scholar 

  10. Madoff DC, Brathwaite CE, Manzione JV, et al. Coexistent rupture of the proximal right subclavian and internal mammary arteries after blunt chest trauma. J Trauma. 2000;48:521–4.

    Article  CAS  Google Scholar 

  11. Ginzburg E, Dygert J, Parra-Davila E, Lynn M, Almeida J, Mayor M. Coronary artery stenting for occlusive dissection after blunt chest trauma. J Trauma. 1998;45:157–61.

    Article  CAS  Google Scholar 

  12. Oliva PB, Hilgenberg A, McElroy D. Obstruction of the proximal right coronary artery with acute inferior infarction due to blunt chest trauma. Ann Intern Med. 1979;91:205–7.

    Article  CAS  Google Scholar 

  13. Boland J, Limet R, Trotteur G, Legrand V, Kulbertus H. Left main coronary dissection after mild chest trauma — favorable evolution with fibrinolytic and surgical therapies. Chest. 1988;93:213–4.

    Article  CAS  Google Scholar 

  14. Hazeleger R, van der Wieken R, Slagboom T, Landsaat P. Coronary dissection and occlusion due to sports injury. Circulation. 2001;103:1174–5.

    Article  CAS  Google Scholar 

  15. Kerwin TC, Ruggie N, Klein LW. Spontaneous coronary artery dissection following low-intensity blunt chest trauma: a case report and review of current treatment options. J Invasive Cardiol. 2002;14:679–81.

    Google Scholar 

  16. Manghat NE, Morgan-Hughes GH, Roobottom CA. Spontaneous coronary artery dissection: appearance and follow-up on multi-detector row CT coronary angiography. Clin Radiol. 2005;60:1120–5.

    Article  CAS  Google Scholar 

  17. Schoenhagen P, Stillman AE, Halliburton SS, White RD. CT of the heart: principles, advances, clinical uses. Cleveland Clin J Med. 2005;72:127–38.

    Article  Google Scholar 

  18. Buys EM, Suttorp MJ, Morshuis WJ, Plokker HW. Extension of a spontaneous coronary artery dissection due to thrombolytic therapy. Cathet Cardiovasc Diagn. 1994;33:157–60.

    Article  CAS  Google Scholar 

  19. Viitasalo MT, Kala R, Eisalo A. Ambulatory electrocardiographic recording in endurance athletes. Br Heart J. 1982;47:213–20.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Catherine Y. Campbell MD, Janet D. Record MD, Aravindan Kolandaivelu MD &  Roy C. Ziegelstein MD

  2. Department of Medicine, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, 21224, Baltimore, MD

    Roy C. Ziegelstein MD

Authors
  1. Catherine Y. Campbell MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Janet D. Record MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aravindan Kolandaivelu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roy C. Ziegelstein MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roy C. Ziegelstein MD.

Additional information

The authors have no conflicts of interest to report.

Drs. W. Lowell Maughan and David R. Thiemann performed cardiac catheterization and percutaneous coronary intervention.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Campbell, C.Y., Record, J.D., Kolandaivelu, A. et al. Chest pain in a young basketball player. J Gen Intern Med 21, C7–C10 (2006). https://doi.org/10.1111/j.1525-1497.2006.00400.x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00400.x

Key words

Search

Navigation