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Referred to the Cardiology Department, the echocardiogram (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C) showed alterations in contractility in the anterior descending artery, with an image suggestive of intramyocardial dissecting haematoma (IDH) (asterisk). The electrocardiogram showed signs of anteroseptal necrosis, and the patient reported an episode of prolonged chest pain a year earlier for which he did not consult. MRI (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B) confirmed the diagnosis, with a large intramyocardial thrombus delimited by the infarcted endocardium (red arrows) and epicardium (green arrows). Conservative management was decided upon at the medical-surgical consultation due to stability and comorbidities.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">IDH is a rare mechanical complication of myocardial infarction, with only 40 cases described in the literature as of 2018. While pseudoaneurysm consists of a complete rupture of the myocardial wall contained by the pericardium, IDH is defined by a neocavity filled with blood, limited by the myocardium itself. 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Journal Information
Vol. 160. Issue 11.
Pages e9 (June 2023)
Vol. 160. Issue 11.
Pages e9 (June 2023)
Image in medicine
Intramyocardial dissecting hematoma
Hematoma disecante intramiocárdico
Pedro Martínez-Losas
, Laura Mora, Cristina de Cortina Camarero
Corresponding author
Servicio de Cardiología, Hospital Universitario Infanta Leonor, Madrid, Spain
Article information
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