CIRCUMFLEX CORONARY-ARTERY DISSECTION FOLLOWING WATERSKIING

A previously healthy 35-year-old woman experienced chest discomfort fo llowing mild blunt chest trauma while waterskiing. During the followin g 48 h, she underwent evaluation in two separate emergency departments (EDs) where she was found to have normal ECGs and cardiac enzyme valu es. She was subsequently discharged from both EDs. Twelve hours after the second ED visit, she was discovered unconscious at home and was re suscitated from ventricular fibrillation. Emergency cardiac catheteriz ation demonstrated moderate circumflex disease without angiographic ev idence of a false lumen or intimal flap. Left ventriculography demonst rated posterolateral wall hypokinesis. Eight days after remaining vent ilator-dependent and unconscious, the patient was declared brain-dead. At autopsy, the patient was found to have a dissection of the circumf lex artery. Waterskiing is an unusual source of cardiac trauma; howeve r, we believe this to be the first reported case of dissection in the circumflex artery following blunt chest trauma.