Related Experiment Video
Updated: Jun 12, 2026
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Spontaneous remission of ruptured intramyocardial hematoma detected upon serial multidetector computed tomography
Yu-Cheng Hsieh1, I-Chen Tsai, Chen-Rong Tsao
1Cardiovascular Center, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
Insights
Intramyocardial hematoma, a rare complication of percutaneous coronary intervention, can resolve spontaneously. Serial multidetector computed tomography effectively tracked the healing of a ruptured hematoma, showing complete remission after one year.
Area of Science:
- Cardiology
- Radiology
Background:
- Intramyocardial hematoma is a rare complication following percutaneous coronary intervention (PCI) for acute myocardial infarction (MI).
- Clinical outcomes are variable, ranging from spontaneous resolution to fatal events, necessitating close monitoring.
Observation:
- A 69-year-old male developed an intramyocardial hematoma with right ventricular rupture during PCI for an acute inferior MI.
- The patient remained hemodynamically stable, leading to a conservative management strategy.
Findings:
- Serial multidetector computed tomography (MDCT) was used to monitor the hematoma's progression and healing.
- MDCT imaging demonstrated complete remission of the intramyocardial hematoma after one year.
Implications:
- This case highlights the utility of serial MDCT in documenting the natural history and resolution of intramyocardial hematomas.
- MDCT may be a valuable tool for managing and assessing outcomes in patients with this rare complication.
Abstract:
Intramyocardial hematoma is a rare sequela of percutaneous coronary intervention after acute myocardial infarction. Clinical outcomes of intramyocardial hematoma vary from asymptomatic remission to cardiac death. Close follow-up is imperative. Herein, we report the case of a 69-year-old man who had sustained an acute inferior myocardial infarction. During primary percutaneous coronary intervention to the occluded right coronary artery, an intramyocardial hematoma developed and immediately ruptured into the right ventricle. Because the patient remained hemodynamically stable, a conservative approach was taken. Follow-up with serial multidetector computed tomographic imaging elucidated the course and extent of the hematoma and clearly revealed the healing process. After 1 year, this method of imaging showed complete remission of the hematoma. To the best of our knowledge, this is the 1st use of serial multidetector computed tomography to document the remission of an intramyocardial hematoma that ruptured after complicated percutaneous coronary intervention. We believe that multidetector computed tomography is useful in tracing the natural history of intramyocardial hematomas.
