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Eur J Cardiothorac Surg 2008;34:1265-1267. doi:10.1016/j.ejcts.2008.08.031
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Case reports

The blue man: an unusual happy end of a spontaneous rupture of a coronary artery

Marie L. Moonena,1, Michel Hanssena, Marc A. Radermeckerb, Patrizio Lancellottia,*

a Department of Cardiology, University Hospital Sart Tilman, B-4000 LIEGE, Belgium
b Department of Thoracic and Cardiovascular Surgery, University Hospital Sart Tilman, B-4000 LIEGE, Belgium

Received 24 April 2008; received in revised form 19 August 2008; accepted 27 August 2008.

* Corresponding author. Tel.: +32 4 3667194; fax: +32 4 3667195. (Email: plancellotti{at}chu.ulg.ac.be).

We report the case of spontaneous rupture of a coronary artery. It was that of a 56-year-old man admitted for dyspnoea and anterior thoracic pain. The most striking feature on physical examination was the marked cyanosis of his face, upper part of the thorax and the upper limb. The patient was haemodynamically unstable with tachycardia and hypotension. Cardiac tamponade was confirmed by echocardiography and computed tomography of the thorax. The patient was transferred for surgery. Emergency sternotomy revealed pericardial bloody effusion and a continuous bleeding around the posterior interventricular artery. No other perioperative findings could explain the haemopericardium. Haemostasis was obtained by a suture of the bleeding coronary artery.

Key Words: Spontaneous rupture • Coronary artery • Contrast echo • MDCT






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Copyright © 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.