Infark Miokard Non-Segmen Elevasi ST pada Kasus Fraktur Terbuka Multipel: Laporan Kasus
DOI:
https://doi.org/10.22225/wmj.10.2.13400.75-79Kata Kunci:
NSTEMI, type 2 myocardial infarction, non-thoracic trauma, fractureAbstrak
Latar Belakang. Infark miokardium (IM) umumnya terjadi akibat aterosklerosis koroner. Namun, dalam kondisi tertentu, trauma dapat berperan sebagai pencetus terjadinya IM. Laporan kasus ini membahas kejadian NSTEMI pada pasien dengan fraktur terbuka multiple dan membahas hipotesis yang berkontribusi terhadap terjadinya infark miokard dalam konteks trauma non-toraks.
Presentasi Kasus. Seorang laki-laki, berusia 53 tahun datang ke instalasi gawat darurat (IGD) paska kecelakaan sepeda motor. Pasien dirawat dengan fraktur terbuka multiple dan mengalami infark miokardium pada hari ke-1 perawatan.
Diskusi. Infark miokardium (IM) pada fraktur terbuka dapat terjadi akibat dari rupturnya plak arterosklerosis, ketidakseimbangan oksigen dan/ atau meningkatnya mediator pro-inflamasi akibat proses dari remodeling tulang atau stress paska trauma.
Kesimpulan. Infark miokardium (IM) dapat terjadi pada pasien trauma non-toraks melalui beberapa mekanisme kompleks. Peningkatan kewaspadaan terhadap kemungkinan komplikasi kardiovaskular berperan penting dalam penatalaksanaan pasien., terutama pada pasien trauma dengan faktor risiko kardiovaskular.
Referensi
1. Karolewski J, Williams JK, Weaver N, Meakes S, Gane K, Balogh ZJ. Epidemiology of myocardial injury in trauma patients: proposed phenotypes for future research. European Journal of Trauma and Emergency Surgery. 2025;51(1).
2. Liu X, Wang A, Liu T, Li Y, Chen S, Wu S, et al. Association of traumatic injury and incident myocardial infarction and stroke: a prospective population-based cohort study. Rev Cardiovasc Med. 2023;24(5).
3. Culhane JT, Mangold MA, Freeman C. Analysis of predictors of myocardial infarction in trauma with development of a trauma cardiac risk index. Cureus. 2021.
4. Bhuller SB, Hasan SR, Weaver J, Lieser M. Acute myocardial infarction following penetrating thoracic trauma: a case report and review of literature. Int J Surg Case Rep. 2019;65:358-360.
5. Fujiwara K, Ohsaka H, Madokoro S, Yanagawa Y. Fatal acute myocardial infarction after multiple blunt injuries involving the chest. J Emerg Trauma Shock. 2018;11(3):230-232.
6. Li X, Wang Z, Yang Y, Meng F, He Y, Yang P. Myocardial infarction following a blunt chest trauma: a case report. Medicine (United States). 2019;98(4).
7. Chapman AR, Taggart C, Boeddinghaus J, Mills NL, Fox KAA. Type 2 myocardial infarction: challenges in diagnosis and treatment. Eur Heart J. 2024. Available from: http://www.ncbi.nlm.nih.gov/pubmed/39658094
8. Elhawary H, Baradaran A, Abi-Rafeh J, Vorstenbosch J, Xu L, Efanov JI. Bone healing and inflammation: principles of fracture and repair. Semin Plast Surg. 2021;35(3):198-203.
9. Tsioufis P, Theofilis P, Tsioufis K, Tousoulis D. The impact of cytokines in coronary atherosclerotic plaque: current therapeutic approaches. Int J Mol Sci. 2022;23.
10. Weber B, Lackner I, Knecht D, Braun CK, Gebhard F, Huber-Lang M, et al. Systemic and cardiac alterations after long bone fracture. Shock. 2020;54(6):761-773.
11. Hietala P, Strandberg M, Strandberg N, Gullichsen E, Airaksinen KEJ. Perioperative myocardial infarctions are common and often unrecognized in patients undergoing hip fracture surgery. Journal of Trauma and Acute Care Surgery. 2013;74(4):1087-1091.
12. Zheng ML, Du XP, Yang XC, Zheng ML. Bone fracture is associated with incident myocardial infarction in long-term follow-up. BMC Public Health. 2024;24(1).
13. Dutta P, Courties G, Wei Y, Leuschner F, Gorbatov R, Robbins CS, et al. Myocardial infarction accelerates atherosclerosis. Nature. 2012;487(7407):325-329.
14. Nicolo F, Perrone S, Geuna F, Macrini M, Muscoli S, Perrone MA. NSTEMI in a patient admitted for multiple spinal fractures: a clinical case report. J Pathol Locomot Appar. 2020;XIX.
15. Padda J, Khalid K, Hitawala G, Batra N, Pokhriyal S, Mohan A, et al. Acute anemia and myocardial infarction. Cureus. 2021.
16. Bekbossynova M, Saliev T, Mukarov M, Sugralimova M, Batpen A, Kozhakhmetova A, et al. Indirect myocardial injury in polytrauma: mechanistic pathways and the clinical utility of immunological markers. J Cardiovasc Dev Dis. 2025;12.
17. Culhane JT, Drogan J, Okeke RI, Harjai K. Elevated cardiac troponin is most often associated with type 2 myocardial infarction in trauma patients. Cureus. 2023.
Unduhan
Diterbitkan
Cara Mengutip
Terbitan
Bagian
Lisensi
Hak Cipta (c) 2025 Made Ratih Santi Devinta, I Gusti Agung Bagus Krisna Jayantika
Artikel ini berlisensiCreative Commons Attribution-ShareAlike 4.0 International License.
