Septal dissection after inferior acute myocardial infarction

Sanchez, Eládio Flores; Cid-Cumplido, Manuela; Tarhini, Ibrahim; Pineda, Tomás; González, José Siles

doi:10.7775/rac.80.4.12

Cited by 2 publications

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“…Anterior myocardial infarction, and 2 our cases occurred in most patients with MI 66%. The rest presented with MI in other locations . In patients with MI, the mean time from initial symptoms to the diagnosis of IDH was 9 days (from 30 minutes to 42 days).…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2018

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Until recently, diagnosis of intramyocardial dissecting hematoma (IDH) was performed during necropsy or at surgery. During the recent years, echocardiography has permitted clinical suspicion, which usually needed confirmation with magnetic resonance imaging (MRI). In this study, we tried to define clinical and imaging features of IDH and predictors of mortality. We searched the literature for proven cases of IDH and analyzed them together with 2 of our cases. A total of 40 cases of IDH (2 our original and 38 literature cases) were included. Mean age was 60. In 32 cases, IDH was a complication of myocardial infarction (MI), in 66% anterior, a mean time from symptoms to diagnosis was 9 days. Thirty-eight % underwent surgery. In-hospital mortality was 23%. Multivariate analysis showed that the strongest independent predictor of mortality (42%) was EF < 35%; in patients with age >60, mortality risk was 44%; and in the presence of MI or late diagnosis (>24 hours since symptoms started), mortality risk was 50%. In summary, IDH is a diagnostic challenge. A high level of suspicion is needed for prompt diagnosis. Management of these patients is based on individual clinical and imaging parameters. Low EF, age > 60, and late diagnosis, all are predictors of in-hospital mortality.

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Section: Resultsmentioning

confidence: 99%

“…ST elevation was found in 17 of 40 patients during the presentation (43%). In 5 patients, communication between the left and right ventricles was found, in 2 with anterior MI, and in 3 with inferior . Fifteen patients underwent surgery (38%).…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2018

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“…A total of 108 reports were identified, of which 22 full‐text articles with 36 cases met our inclusion criteria (including 15 case reports, 3 case series, 2 systematic reviews, one prospective study, and one letter) . The included studies are summarized in Table of the supplementary material.…”

Section: Resultsmentioning

confidence: 99%

Postinfarction intramyocardial dissection, an interesting case report and systematic review

et al. 2019

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Intramyocardial dissection (IMD) with ventricular septal rupture (VSR) following myocardial infarction (MI) is a rare subacute form of cardiac rupture. The evidence available in this regard is scarce. We aimed to share our experience and conduct a systematic review of previous cases. We searched the literature and performed a systematic review of previous cases. A total of 37 cases of IMD with VSR were included (1 our original and 36 literature cases). Mean age was 68 ± 8 years and 20 (54.1%) patients were male. Anterior and inferior MI were observed in 14 (37.8%) and 23 (62.2%) cases, respectively. The dissected area was the septum, RV, both septum and RV, or LV apex in 21 (56.8%), 9 (24.3%), 5 (13.5%), and 2 (5.4%), respectively. Apicoseptal and inferoseptal VSR were observed in 15 (40.5%) and 22 (59.5%) cases, respectively. At least one occluded artery was observed in 29 (90.6%) of cases. Reperfusion therapy was done for 15 (40.5%) cases before the VSR occurred.Surgery, percutaneous, and medical therapy were done for 26 (70.3%), 3 (8.1%), and 7 (18.9%) cases, respectively. The mortality rate was significantly higher in the medical versus surgical-treated group (85.7% versus 42.3%, P = .027). There was a trend to higher mortality in the group with dissection of both septum and RV (P = .15). We concluded that echocardiography has a critical role in diagnosing this complication.Surgery is mandatory in IMD with VSR.

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Septal dissection after inferior acute myocardial infarction

Cited by 2 publications

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

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

Postinfarction intramyocardial dissection, an interesting case report and systematic review

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