J 2023

Post-myocardial infarction left ventricular intramyocardial dissecting hematoma

VEJMĚLEK, Adam, Petr NĚMEC a Petr FILA

Základní údaje

Originální název

Post-myocardial infarction left ventricular intramyocardial dissecting hematoma

Autoři

VEJMĚLEK, Adam (203 Česká republika), Petr NĚMEC (203 Česká republika, domácí) a Petr FILA (203 Česká republika, domácí)

Vydání

cor et Vasa, PRAGUE 2, CZECH SOC CARDIOLOGY & CZECH SOC CARDIOVASCULAR SURGERY, 2023, 0010-8650

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 0.200 v roce 2022

Organizační jednotka

Lékařská fakulta

DOI

UT WoS

000959862100018

Klíčová slova anglicky

Complication of myocardial  infarction; Echocardiography; Intramyocardial dissecting  hematoma; Myocardial infarction

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 26. 6. 2024 10:36, Mgr. Tereza Miškechová

Anotace

V originále

Background: Intramyocardial dissecting hematoma (IDH) is blood-filled cavitation in the cardiac wall that can occur as a complication of myocardial infarction, chest trauma, or percutaneous intervention. It can develop in the left ventricular free wall, the right ventricle, or the interventricular septum.Case report: The case report describes a patient with IDH as a rare complication of myocardial infarction. The patient was hospitalized for ongoing irritating cough three months after ST elevated myocardial infarction treated with percutaneous coronary intervention. The echocardiography showed the image of a pseudoaneu-rysm of the left ventricle. The patient underwent surgery where a cavitation inside the left ventricle myo-cardial wall communicating with the left ventricle was found. The inner and outer border of the cavitation included myocardium, therefore diagnosis of IDH was established. The communication and the cavitation were closed with pledgeted sutures and a direct suture with a mesh stripe. Postoperative hospitalization was without complications and the patient was dismissed the eighth day after the surgery.Discussion: Diagnosis of IDH consists of anamnestic information of myocardial infarction and assessment on echocardiography. On echocardiography the IDH shows as a neocavitation within the heart wall with an echo-lucent center. The differential diagnosis of IDH includes aneurysm, pseudoaneurysm of the heart, thrombus of the ventricle and trabeculae.Conclusion: The IDH is a post-infarction complication important to include in the differential diagnosis of newly formed cavitation inside the ventricle wall seen on echocardiography. Conservative management is suggested when the IDH is small and not growing. Surgery is indicated if the patient is unstable or the IDH is large or growing.