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Septal rupture with right ventricular wall dissecting haematoma communicating with left ventricle after inferior

Luisa De Gennaro1, Natale Daniele Brunetti, Giovanni Ramunni

  • 1Cardiology Department, 'San Giacomo' Hospital, Monopoli, Bari, Italy.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|January 29, 2010
PubMed

Insights

An 86-year-old man presented with abdominal pain and signs of myocardial infarction. Echocardiography revealed an intra-mural hematoma dissecting the right ventricle, with an unusual communication to the left ventricle.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Internal Medicine

Background:

  • Inferior myocardial infarction can present with atypical symptoms.
  • Intra-mural hematomas are rare cardiovascular emergencies.

Observation:

  • An 86-year-old male experienced abdominal pain and electrocardiogram (ECG) findings suggestive of inferior myocardial infarction.
  • Transthoracic, transesophageal, and contrast echocardiography were performed.
  • Imaging revealed a septal intra-mural hematoma dissecting the right ventricle wall.

Findings:

  • The hematoma partially obliterated the right ventricle lumen.
  • Doppler examination identified a patent communication between the hematoma and the left ventricle.
  • Extensive thrombosis was noted within the dissecting hematoma.

Implications:

  • This case highlights a rare presentation of intra-mural hematoma mimicking myocardial infarction.
  • Echocardiography is crucial for diagnosing complex cardiac pathologies.
  • Conservative management may be an option in select cases, even with extensive hematoma.

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