A rare complication of myocardial infarction.
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ABSTRACT:
SUBMITTER: Rao U
PROVIDER: S-EPMC4832625 | biostudies-literature | 2012
REPOSITORIES: biostudies-literature
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A rare complication of myocardial infarction.
Rao Usha U Marinescu Mirela M MM
Heart Asia 20121016 1
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Project description: Not available
| S-EPMC6683213 | biostudies-literature
Project description:BackgroundMyocardial abscess is a very rare life-threatening suppurative infection of the heart. Usually, myocardial abscess is a complication of infective endocarditis, and it is rarely associated with isolated myocardial infection. We present a case of an isolated myocardial abscess presenting with acute myocardial infarction.Case summaryA 61-year-old man with a history of diabetes mellitus and coronary artery disease presented with a 3-h history of chest pain and inferior ST elevation. He had been treated for right-sided pneumonia 1.5 months prior to admission. Coronary angiography revealed acute occlusion of the posterolateral ventricular artery, and he underwent balloon angioplasty, which successfully restored TIMI-3 blood flow. Unfortunately, the patient went into cardiac arrest several hours later from which he could not be resuscitated. A post-mortem revealed a myocardial abscess in the inferior wall of the left ventricle.DiscussionMyocardial abscess is a challenging diagnosis due to the speed of clinical deterioration and rarity. High clinical suspicion and urgent multimodality imaging may aid in the diagnosis.
| S-EPMC10118630 | biostudies-literature
Project description: Not available
| S-EPMC9050574 | biostudies-literature
Project description:Intramyocardial dissecting haematoma is a rare complication of myocardial infarction (MI) associated with high mortality rates. Studies and research of this occurrence are limited largely to isolated case reports or case series. We report a case of late presenting MI, where on initial echocardiogram had what was thought to be an intraventricular clot. However, upon further evaluation, the patient actually had an intramyocardial haematoma, with the supporting echocardiographic features to distinguish it from typical left ventricular (LV) clot. While this prevented the patient from receiving otherwise unnecessary anticoagulation, this diagnosis also put him at a much higher risk of mortality. Despite exhaustive medical and supportive management, death as consequence of pump failure occurred after 2 weeks. This report highlights the features seen on echocardiography which support the diagnosis of an intramyocardial haematoma rather than an LV clot, notably the various acoustic densities, a well visualized myocardial dissecting tear leading into a neocavity filled with blood, and an independent endocardial layer seen above the haematoma. Based on this report, we wish to highlight the importance of differentiating intramyocardial haematomas from intraventricular clots in patients with recent MI.
| S-EPMC6601172 | biostudies-literature
Project description:BackgroundDissecting intramural hematoma is a rare complication of acute myocardial infarction (AMI) and has been associated with increased mortality. There has been paucity of literature to establish protocols and guidelines for management in such cases.Case presentationWe hereby report the case of a 45-year-old male patient with left ventricular intramural dissecting hematoma (LV-IDH) who presented with chest pain and breathlessness and diagnosed as non-ST-elevation myocardial infarction (NSTEMI). Transthoracic echocardiography (TTE) was performed showing LV-IDH, confirmed with cardiac magnetic resonant imaging (cMRI). Selective coronary arteriography (CAG) was performed showing significant obstructive coronary artery disease (CAD). Further management with conservative approach involved discussion with patient, cardiothoracic surgeon and cardiology team including heart failure specialist and interventional cardiology.ConclusionsThis case describes a rare complication of AMI and also focuses on utility of TTE and cMRI in the diagnosis of this rare complication. Both diagnosis and management are challenging and have to be individualized in similar cases. Multidisciplinary care coordination is important in management of patients with this diagnosis.
| S-EPMC8895780 | biostudies-literature
Project description:Intramyocardial dissecting haematoma is a rare complication of myocardial infarction (MI) associated with high mortality rates. Studies and research of this occurrence are limited largely to isolated case reports or case series. We report a case of late presenting MI, where on initial echocardiogram had what was thought to be an intraventricular clot. However, upon further evaluation, the patient actually had an intramyocardial haematoma, with the supporting echocardiographic features to distinguish it from typical left ventricular (LV) clot. While this prevented the patient from receiving otherwise unnecessary anticoagulation, this diagnosis also put him at a much higher risk of mortality. Despite exhaustive medical and supportive management, death as consequence of pump failure occurred after 2 weeks. This report highlights the features seen on echocardiography which support the diagnosis of an intramyocardial haematoma rather than an LV clot, notably the various acoustic densities, a well visualized myocardial dissecting tear leading into a neocavity filled with blood, and an independent endocardial layer seen above the haematoma. Based on this report, we wish to highlight the importance of differentiating intramyocardial haematomas from intraventricular clots in patients with recent MI.
| S-EPMC6601172 | biostudies-literature
Project description:BackgroundCaseous mitral annular calcification (MAC) is an under-diagnosed division of calcific mitral valve disease that has recently been reported to have increased propensity for embolic disease. Early recognition of this entity as a cause of embolic disease can lead to prevention of occlusive vascular disease and long-standing complications.Case summaryWe present the case of a patient with end-stage renal disease who presented for evaluation of chest pain and was found to have ST-segment myocardial infarction. Despite thrombectomy and stenting, he had multiple recurrent events, and imaging evaluation demonstrated caseous MAC with mobile components. He was taken for surgical replacement of the mitral valve, with pathology confirming diagnosis.DiscussionCaseous MAC may represent an increased risk of embolic disease. Better understanding of this pathology and it's propensity for embolic disease will be important to best determine treatment plans and timing of operative intervention.
| S-EPMC8759494 | biostudies-literature
Project description:BackgroundIntramyocardial dissecting hematoma (IDH) is a rare mechanical complication following myocardial infarction (MI), and only a few isolated cases have been reported to date. IDH presents with diverse clinical manifestations, often resulting in missed or misdiagnosed cases due to limited physician understanding. The diagnosis and treatment of IDH is a major challenge.Case presentationsWe report a case of acute extensive anterior MI in a 73-year-old woman, who underwent percutaneous coronary intervention (PCI); the left ventricular intramyocardial dissecting hematoma (LVIDH) penetrated the right ventricular outflow tract (RVOT), resulting in thrombus formation and subsequent RVOT obstruction. Clinically insignificant IDH was detected by transthoracic echocardiography (TTE) at 3 days, 43 days, and 75 days post-PCI, with characteristic changes in the left ventricular wall ultrasound images. This unusual case highlights the important role of continuous transthoracic echocardiography in identifying this rare complication of LVIDH. After a detailed discussion with the patient, the choice between conservative or surgical management of IDH depends on factors such as the size of the hematomae, left ventricular systolic function, and the patient's clinical and haemodynamic status. In this particular case, conservative management was chosen by the patient who declined surgery but unfortunately succumbed to cardiogenic shock.ConclusionsThis case describes a rare complication of acute myocardial infarction (AMI) and also focuses on the utility of TTE in the diagnosis of this rare complication. Whether LVIDH is treated conservatively or surgically requires careful evaluation to achieve the best prognosis for the patient.
| S-EPMC11465562 | biostudies-literature
Project description:BackgroundIntramyocardial dissecting haematoma is a rare and potentially life-threatening complication of myocardial infarction (MI). Only a few isolated cases have been reported so far.Case summaryWe report the case of a patient with a large, obstructing intramyocardial haematoma of the ventricular septum following MI due to plaque rupture of the right coronary artery (RCA) and following successful coronary intervention. The clinically inapparent haematoma was discovered during routine echocardiography and confirmed by both computed tomography (CT) and magnetic resonance imaging (MRI). With non-surgical treatment, the patient remained clinically stable. Repeated echocardiography showed gradual regression of the haematoma. Follow-up echocardiography 3 months after the initial diagnosis demonstrated no evidence of septal haematoma.DiscussionThis report suggests that even large intramyocardial haematoma may recede without operative intervention. Echocardiography, CT, and MRI are all helpful in quantifying the size of the haematoma. The appropriate management should be patient-oriented, depending on clinical stability and progression of the haematoma. Conservative treatment in clinically stable patients suffering from septal haematoma following MI and coronary intervention can be a feasible option.
| S-EPMC7954273 | biostudies-literature
Project description:Here, we report a case of ventricular septal perforation complicated with right ventricular infarction after inferior acute myocardial infarction, which was associated with a poor clinical outcome despite the successful surgical treatment.
| S-EPMC10577155 | biostudies-literature