Long-term Follow-up of Intramyocardial Dissecting Hematomas Complicating Acute Myocardial Infarction

Intramyocardial Dissecting Hematoma after Acute Myocardial Infarction—Echocardiographic Features and Clinical Outcome

“…Echocardiographic diagnosis of IDH was based on the presence of at least three of the following signs: (1) the formation of one or more neo‐cavitation in the MI area with an echolucent center, which enlarges during systole and regresses during diastole; (2) thin and mobile endomyocardial border surrounding the area of myocardial defect with totally intact epicardium; (3) continuity between the dissecting hematoma and either of the ventricular cavities, evidenced by color Doppler; (4) partial or complete spontaneous retraction of the dissection flap confirmed by color Doppler flow cessation; (5) communication between the two ventricles across an undulating or serpiginous course on interventricular septum; (6) IDH complicated with VSR, pseudoaneurysm, papillary muscle or chordal rupture and PE.…”

“…PubMed was searched up to May 2015 using the following terms: myocardial dissection, myocardial dissecting, myocardial dissecting hematoma, intramyocardial dissecting hematoma, dissection intramyocardial hematoma, and acute myocardial infarction. After careful review of the full text of each paper, a total of 60 cases with IDH after acute MI were selected, including a previously published case report of a series of 15 patients, and another series of 15 patients reported by Vargas‐Barron and colleagues . We extracted patient's age, gender, MI location, dissection location, treatment strategy, and clinical outcome from all published series.…”

Intramyocardial dissecting hematoma: Two case reports and a meta‐analysis of the literature

“…Nevertheless, a high level of suspicion is needed during the clinical and echocardiographic examination of these patients in the intensive coronary care unit, in order to be referred for magnetic resonance imaging (MRI). Management of intramyocardial dissecting hematoma is controversial: Although it is often termed subacute rupture not all such patients should be operated, some may be managed conservatively. Previously published series of patients are diverged and include up to 15 cases.…”

Chronic postinfarction pseudo‐pseudoaneurysm diagnosed by cardiac MRI

“…On the other hand, in a number of cases transthoracic, or transesophageal echocardiography and left ventricular angiography resulted in a misdiagnosis-usually of pseudoaneurysm-and the diagnosis of pseudo-pseudoaneurysm became established only during cardiac surgery (1,2,12,18). In clinically and hemodynamically stable patients some authors prefer noninvasive treatment and close observation, since spontaneous resolution of the condition may occur (5)(6)(7)(8). So far, only one case of persisting postinfarction pseudo-pseudoaneurysm was reported.…”

“…The chance of survival is thought to be low if corrective surgery is not performed (3). On the other hand, in some cases a spontaneous resolution of the pseudo-pseudoaneurysm was also detected (5)(6)(7)(8). Occasionally the lesion becomes chronic (9).…”