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Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
14:19

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Published on: October 14, 2016

Dissecting intramyocardial hematoma: clinical presentation, pathophysiology, outcomes and delineation by

Jesús Vargas-Barrón1, Francisco-Javier Roldán, Angel Romero-Cárdenas

  • 1Institute of Cardiology, Ignacio Chavez, México, DF, Mexico. eco_vargas@terra.com.mx

Echocardiography (Mount Kisco, N.Y.)
|November 20, 2008
PubMed

Insights

Dissecting intramyocardial hematoma (DIH) complicates acute myocardial infarction (AMI), often involving the septum and leading to high mortality. Echocardiography effectively diagnoses DIH and its complications post-AMI.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Pathology

Background:

  • Dissecting intramyocardial hematoma (DIH) with serpiginous tracts has been observed in myocardial fibers.
  • DIH occurs in both the septum and left ventricle free wall.

Purpose of the Study:

  • To investigate the characteristics and outcomes of patients with DIH following acute myocardial infarction (AMI).

Main Methods:

  • Studied 15 patients with AMI and DIH confirmed by echocardiography (transthoracic/transesophageal) and intraoperative/necropsy findings.
  • Assessed hematoma location (septal vs. free wall), myocardial infarction extent, and mortality.
  • Utilized echocardiography to visualize DIH acoustic densities, extension, reabsorption, and ventricular communication.

Main Results:

  • DIH predominantly affected the septum in 9 patients and the left ventricle free wall in the remaining.
  • Myocardial infarction involved the anterior wall in 13 patients and the inferior wall in 2.
  • Overall mortality was 47%, with 78% mortality in the septal hematoma group. Echocardiography showed evolving DIH characteristics.

Conclusions:

  • Echocardiography is the preferred noninvasive method for diagnosing suspected myocardial rupture and DIH post-myocardial infarction.
  • DIH, particularly septal hematoma, is associated with significantly higher mortality after AMI.
Abstract

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