Abstract
BACKGROUND: Trauma-related myocardial infarction (MI) is rare. In regional and rural settings, ST-segment elevation myocardial infarction (STEMI) may necessitate systemic thrombolysis despite concurrent relative contraindications. CASE SUMMARY: A 47-year-old woman experienced an anterior STEMI immediately following a motor vehicle accident in a regional area. Given definitive care was at least 3 hours away, multidisciplinary consultation was undertaken, and administration of systemic thrombolysis was recommended. Successful coronary reperfusion was achieved, but the patient developed internal iliac artery bleeding requiring embolization. Coronary angiography revealed a mild left anterior descending artery stenosis. Cardiac magnetic resonance imaging confirmed MI with evidence of microvascular obstruction, late gadolinium enhancement, and myocardial edema in the territory of the left anterior descending artery. DISCUSSION: This is to our knowledge the only reported case of systemic thrombolysis for trauma-related MI in the past 30 years. TAKE-HOME MESSAGE: Multidisciplinary collaboration in regional and rural settings is important to ensure optimal outcomes where relative contraindications to thrombolysis may exist.