Project description:Intramyocardial dissecting hematoma is a form of cardiac rupture caused by myocardial infarction, percutaneous coronary intervention, or trauma. It is a cavity between myocardial fibers caused by partial rupture of the ventricular wall. Therapeutic management, including the timing for surgical approach, has not been standardized. We present a case series describing 4 patients. (Level of Difficulty: Intermediate.).

| S-EPMC9664011 | biostudies-literature

Left Ventricular Intramyocardial Dissecting Hematoma.

Project description: Not available

| S-EPMC8712951 | biostudies-literature

Early Spontaneous Remission of Intramyocardial Dissecting Hematoma.

Project description:Intramyocardial dissecting hematoma is a rare but potentially fatal complication of myocardial infarction. The decision to adopt a surgical or conservative strategy may depend on the clinical and hemodynamic stability of patients. Regardless, the precise and temporal assessment of the structure of hematoma is imperative. We herein report the first case of a patient with early spontaneous remission of intramyocardial dissecting hematoma successfully managed by a conservative approach with multimodality imaging.

| S-EPMC5478569 | biostudies-literature

Post myocardial infarction left ventricular intramyocardial dissecting hematoma penetrated right ventricular outflow tract: a rare complication report.

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

Left Ventricular Intramyocardial Dissecting Hematoma With Late Ventricular Tachycardia Storm.

Project description:This case describes an uncommon discovery of a left ventricular intramyocardial dissecting hematoma in a patient experiencing a ventricular tachycardia storm. Imaging modalities, including 2-dimensional and 3-dimensional echocardiography and cardiac magnetic resonance, assisted in diagnosing the intramyocardial dissecting hematoma. The patient underwent conservative treatment and received a single-chamber implantable cardioverter defibrillator.

| S-EPMC11442180 | biostudies-literature

A Rare Case of Intramyocardial Dissecting Hematoma following Acute Myocardial Infarction

Project description: Not available

| S-EPMC10529293 | biostudies-literature

Getting over a Broken Heart: Intramyocardial Dissecting Hematoma as Late Presentation of Myocardial Infarction.

Project description: Not available

| S-EPMC6058351 | biostudies-literature

Ventricular Intramyocardial Dissecting Hematoma: What Is its True Clinical Evolution and the Best Treatment?

Project description:Intramyocardial dissecting hematoma (IDH), in the setting of an acute coronary syndrome, is a rare type of cardiac rupture. However, the best treatment for IDH in each clinical scenario is not clearly defined. We present a case in which the best approach for IDH and its final outcome are discussed.

| S-EPMC10774762 | biostudies-literature

Coronary artery intramural hematoma, a rare complication of percutaneous coronary intervention.

Project description:Coronary artery intramural hematoma is a rare complication of percutaneous coronary intervention which develops from intimal tear of coronary artery and propagates by blood accumulation along the medial surface of adjacent segment. Fifty-three-year-old male presented with nonexertional chest pain; he was referred after a positive stress test with+ moderate lateral wall ischemia. Coronary angiography showed 80% lesion in mid-left anterior descending artery (mLAD). Angiogram after angioplasty with 2.0 mm × 15 mm balloon and 3.0 mm × 15 mm drug-eluting-stent demonstrated a new stenotic lesion distal to stented mLAD segment. Subsequently, an overlapping 3.0 mm × 30 mm stent was placed with effective restoration of blood flow through LAD. During percutaneous coronary intervention (PCI), balloon predilatation can result in plaque fracture and stent deployment may cause intimal tear forming intramural hematoma which can lead to post-PCI myocardial infarction necessitating prompt detection by intravascular imaging with intravascular ultrasound and optical coherence tomography. Management is based on individual patient's characteristics and includes medical therapy, angiographic surveillance or repeat PCI.

| S-EPMC9364049 | biostudies-literature

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