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@article{2414360,
author = {Vejmělek, Adam and Němec, Petr and Fila, Petr},
article_location = {PRAGUE 2},
article_number = {1},
doi = {http://dx.doi.org/10.33678/cor.2022.089},
keywords = {Complication of myocardial infarction; Echocardiography; Intramyocardial dissecting hematoma; Myocardial infarction},
language = {eng},
issn = {0010-8650},
journal = {cor et Vasa},
title = {Post-myocardial infarction left ventricular intramyocardial dissecting hematoma},
url = {https://e-coretvasa.cz/artkey/cor-202301-0018_post-myocardial-infarction-left-ventricular-intramyocardial-dissecting-hematoma.php},
volume = {65},
year = {2023}
}
TY - JOUR
ID - 2414360
AU - Vejmělek, Adam - Němec, Petr - Fila, Petr
PY - 2023
TI - Post-myocardial infarction left ventricular intramyocardial dissecting hematoma
JF - cor et Vasa
VL - 65
IS - 1
SP - 120-124
EP - 120-124
PB - CZECH SOC CARDIOLOGY & CZECH SOC CARDIOVASCULAR SURGERY
SN - 00108650
KW - Complication of myocardial
KW - infarction
KW - Echocardiography
KW - Intramyocardial dissecting
KW - hematoma
KW - Myocardial infarction
UR - https://e-coretvasa.cz/artkey/cor-202301-0018_post-myocardial-infarction-left-ventricular-intramyocardial-dissecting-hematoma.php
N2 - 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.
ER -
VEJMĚLEK, Adam, Petr NĚMEC and Petr FILA. Post-myocardial infarction left ventricular intramyocardial dissecting hematoma. \textit{cor et Vasa}. PRAGUE 2: CZECH SOC CARDIOLOGY \&{}amp; CZECH SOC CARDIOVASCULAR SURGERY, 2023, vol.~65, No~1, p.~120-124. ISSN~0010-8650. Available from: https://dx.doi.org/10.33678/cor.2022.089.
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