More martial than arts: Coronary artery dissection after chest kick

A 40-year-old male smoker without relevant medical history reported to the emergency department two days after a kick to his unprotected chest during a karate training session. The day before, he had presented with severe chest pain and his general practitioner had prescribed ibuprofen. No ECG had been done. At the emergency department, the patient complained of severe chest pain with breathing or touching the left hemithorax. Vital signs and physical exploration were normal. The 12-lead ECG showed ST-segment elevation in the inferolateral leads (II, III, aVF, V4-V6, Fig.