Early occlusion and late stricture of normal coronary arteries following blunt chest trauma.

A 27-year-old man had inferior myocardial infarction following superficial chest trauma. Coronary arteriography documented an isolated total occlusion of the right coronary artery, probably caused by localized extra-coronary compression, and no other evidence of intrinsic coronary disease. The left anterior descending artery later developed a localized proximal stenosis, most likely due to mural thrombus, which progressed rapidly to cause anterior myocardial infarction despite coronary artery surgery. The etiology of this lesion is discussed and support given to the "encrustation" hypothesis of human atherosclerosis. Exercise thallium scintigraphy proved helpful in the management of this case.