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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Coronary Artery Blockage Be Caused By Injury To The Artery Walls?

I was driving a minivan on the interstate when a sedan crossed the median. We T-boned it. I "Walked away" with bruises on my left shoulder and severe pain the length of my sternum (My wife severely injured her knees which resulted in bilateral knee replacement). After transport to the emergency room I was basically ignored in favor of my wife's injuries. The Sternal pain persisted for about 4 months. Also after about 4 month I began to exhibit ischemia symptom (had difficulty completing my usual 2 mile morning run). The symptoms increased over the next couple months until I could not move faster that a brisk walk. Medical evaluations included a pulmonary function test (fully normal), then a stress echo (9 1/2 minutes, Max HR of 122) (Note: about a yea and a half before the accident I underwent a stress echo for an FAA physical - 14 min 36 Sec. Max hr 174 at age 63), then and angiogram which led to imediate CABGX4 (I was told 90% blockage of the anterior arteries). I have had a great recovery and can reach a HR of over 160 on my treadmill at home (now age 72). Please comment on the hypothesis that the Coronary artery blockage could be the result of injury to the artery walls/lining from processes that were initiated/accelerated by forces of the accident. Note: For me this is an open insurance claim.
Tue, 6 Dec 2016
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Cardiologist 's  Response
hi dear
i am sorry for your accident
coronary artery blockage is a complex phenomenon
many theories have been proposed for it
some of them are

When the arterial endothelium(inner lining of artery) encounters risk factors as diverse as dyslipidemia, vasoconstrictor hormones invollved in hypertension, the products of glycoxidation associated with hyperglycemia( diabetes ), or proinflammatory cytokines derived from excess adipose tissue(obesity), these cells augment the expression of adhesion molecules that promote the sticking of blood leukocytes to the inner surface of the arterial wall. which in long term is associated with formation of plaques in blood vessels, this process begins at a age of 10 years and progresses with time.
as per your query i am sorry but coronary artery blockage s a result of forces of accuident is not yet proved ,nor there is any article documented that coronary artery blockes as a result of external trauma to the body, however certain conditions like pericarditis(inflammation ) of heart as a result of injury or pericardial effusion etc can accelerate this process
but direct relation of external trauma to coronary occlusion is yet to be proved
thanks
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Can Coronary Artery Blockage Be Caused By Injury To The Artery Walls?

hi dear i am sorry for your accident coronary artery blockage is a complex phenomenon many theories have been proposed for it some of them are When the arterial endothelium(inner lining of artery) encounters risk factors as diverse as dyslipidemia, vasoconstrictor hormones invollved in hypertension, the products of glycoxidation associated with hyperglycemia( diabetes ), or proinflammatory cytokines derived from excess adipose tissue(obesity), these cells augment the expression of adhesion molecules that promote the sticking of blood leukocytes to the inner surface of the arterial wall. which in long term is associated with formation of plaques in blood vessels, this process begins at a age of 10 years and progresses with time. as per your query i am sorry but coronary artery blockage s a result of forces of accuident is not yet proved ,nor there is any article documented that coronary artery blockes as a result of external trauma to the body, however certain conditions like pericarditis(inflammation ) of heart as a result of injury or pericardial effusion etc can accelerate this process but direct relation of external trauma to coronary occlusion is yet to be proved thanks