Author + information
- Received April 8, 2009
- Accepted June 21, 2009
- Published online May 25, 2010.
- Pablo Aguiar-Souto, MD,
- Amparo Martínez-Monzonís, MD,
- Anxo Martínez de Alegría Alonso, MD,
- Ramiro Trillo-Nouche, MD and
- Jose R. González-Juanatey, MD, PhD
A 71-year-old man was admitted to the coronary care unit after septal branch perforation (angiogram) during percutaneous coronary intervention of complex stenosis in the left anterior descending coronary artery. Transthoracic echocardiography (Online Video 1) demonstrated an increased interventricular septum thickness (26 mm) with low echo signals core and abnormal motion. These findings suggested the diagnosis of interventricular septal dissecting hematoma. Cardiac magnetic resonance imaging (A, Online Video 2) performed 6 days later showed a diffuse widening (28 mm) and hypokinetic interventricular septum with a low signal (STIR-P2) fusiform neocavitation (hematoma) delimited by an enhanced-signal ring after administration of gadolinium due to myocardial fibrosis. These findings confirmed the initial diagnosis. After conservative treatment, the patient was discharged uneventfully 2 weeks later and remained asymptomatic after 2 months of follow-up, when echocardiographic (Online Video 3) and magnetic resonance imaging studies (B, Online Video 4) showed the resolution of the hematoma.
- Received April 8, 2009.
- Accepted June 21, 2009.
- American College of Cardiology Foundation