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Updated: Jun 28, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
[Postinfarction intramyocardial dissection]
1Instituto Nacional de Cardiología "Ignacio Chávez", INCICH, Juan Badiano Núm. 1, Col. Sección XVI, Tlalpan 14080, México, DF. ccd_vargas@terra.com.mx
Insights
Intramyocardial ventricular dissection complicates acute myocardial infarction, leading to high mortality, especially with septal hematoma. Echocardiography effectively visualizes dissection evolution, guiding diagnosis and management.
Area of Science:
- Cardiology
- Medical Imaging
- Pathology
Context:
- Acute myocardial infarction (AMI) can present with complex intramyocardial complications.
- Intramyocardial ventricular dissection (IVD) is a rare but severe complication of AMI.
- Echocardiography and necropsy are key diagnostic modalities.
Purpose:
- To describe the clinical evolution and echocardiographic findings of 16 patients with acute myocardial infarction and intramyocardial ventricular dissection.
- To correlate dissection location and characteristics with patient outcomes and mortality.
- To evaluate the utility of transesophageal echocardiography (TEE) in diagnosing cardiac rupture secondary to AMI.
Summary:
- This study details the progression of 16 patients diagnosed with acute myocardial infarction complicated by intramyocardial ventricular dissection.
- Dissections involved the septum (10 patients) or left ventricular free wall (6 patients), with anterior wall infarction being most common (14 patients).
- Mortality was 50% overall, rising to 80% in patients with septal hematoma. Echocardiography revealed diverse acoustic patterns reflecting dissection evolution and chamber communication.
Impact:
- Intramyocardial ventricular dissection significantly increases mortality in acute myocardial infarction patients.
- Echocardiographic findings correlate with dissection type and prognosis.
- Transesophageal echocardiography is identified as a crucial non-invasive tool for evaluating suspected cardiac rupture in AMI.
Abstract:
The evolution of 16 patients with acute myocardial infarction in whom the intramyocardial ventricular dissection has been demonstrated with echocardiography, in the operating room and/or during necropsy is described. Ten patients had inital septal hemorrhagic dissection and in 6 patients the dissection was of the free wall of the left ventricle. The myocardial infarction affected the inferior wall of the left ventricle in 2 cases and in 14 the anterior wall. ECG recordings demonstrated extension of the infarction to the right ventricle in 7 of the 16 patients and in 15 a persistent elevated ST segment in the leads associated with the infarction site. There was a 50% global mortality and in the group with septal hematoma it reached 80%. Echocardiographic studies showed different acoustic densities according to the type of evolution: spontaneous reabsortion, extension through the hemorrhagic dissection as well as the communication with ventricular chambers. Based on these results TEE is the non invasive selected method in the sudy of patients with acute myocardial infarction and suspected cardiac rupture.
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