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Intramyocardial hematoma mimicking abnormal left ventricular trabeculation
C Stöllberger1, J Finsterer, F R Waldenberger
12. Medizinische Abteilung, Krankenanstalt Rudolfstiftung, Wien, Austria. claudia.stoellberger@pips.co.at
Insights
Intramyocardial hematoma can mimic tumors on echocardiography. Surgical excision confirmed hematoma, resolving abnormal trabeculations seen post-infarction.
Area of Science:
- Cardiology
- Cardiac Surgery
- Diagnostic Imaging
Background:
- Intramyocardial hematoma is a rare cardiac condition.
- Echocardiography is crucial for diagnosing cardiac abnormalities.
- Left ventricular abnormal trabeculations can suggest skeletal muscle disorders.
Observation:
- A 68-year-old male presented with subacute posterior wall infarction and ventricular fibrillation.
- Initial echocardiography revealed isolated left ventricular abnormal trabeculations.
- Cardiac surgery was performed for severe 3-vessel disease.
Findings:
- An intramyocardial hematoma of the lateral wall was excised during surgery.
- Myocardial and skeletal muscle biopsies were negative for abnormal trabeculations or muscle disorders.
- Postoperative echocardiography showed resolution of the abnormal trabeculations.
Implications:
- This case highlights intramyocardial hematoma as a differential diagnosis for ventricular masses.
- Echocardiographic findings of abnormal trabeculations can be transient and related to hematoma.
- Accurate diagnosis and surgical management are essential for favorable outcomes.
Abstract:
Intramyocardial hematoma may present as a tumor or pseudoaneurysm on echocardiography. A 68-year-old man was admitted with a subacute posterior wall infarction complicated by ventricular fibrillation. Echocardiography showed isolated left ventricular abnormal trabeculations, a finding suggesting an associated skeletal muscle disorder, in the lateral wall. At cardiac surgery, performed 6 weeks later because of severe 3-vessel disease, an intramyocardial hematoma of the lateral wall was excised, and myocardial and skeletal muscle biopsies were taken, which showed neither isolated left ventricular abnormal trabeculations nor skeletal muscle disorder. Postoperatively, echocardiography revealed no abnormal trabeculations.