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Published on: June 11, 2019

A case of circumferential multi-vessel coronary intramural hematoma in a post-menopausal woman

Robin Ducas1, Davinder S Jassal, Farrukh Hussain

  • 1University of Manitoba;

Heart International
|November 4, 2011
PubMed

Insights

Spontaneous coronary artery dissection, specifically intramural hematoma, can be challenging to diagnose and treat. This case demonstrates successful multivessel stenting for a dissection only visible with intravascular ultrasound, emphasizing advanced imaging for atypical presentations.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Spontaneous coronary artery dissection (SCAD) is a recognized but often challenging condition.
  • Intramural hematoma represents a specific type of SCAD.
  • Existing literature primarily details treatment for dissections visible on angiography.

Observation:

  • A case of diffuse intramural hematoma was observed.
  • The dissection was not apparent on standard angiography.
  • Intravascular ultrasound (IVUS) was crucial for visualizing the dissection.

Findings:

  • The patient underwent successful treatment with multivessel drug-eluting stenting.
  • This represents the first reported case of IVUS-detected intramural hematoma treated with stenting.
  • Multimodality imaging, including IVUS and CT, was utilized for diagnosis and treatment planning.

Implications:

  • Highlights the importance of considering SCAD even with atypical or absent angiographic findings.
  • Underscores the diagnostic and therapeutic value of advanced imaging modalities like IVUS.
  • Suggests stenting as a viable treatment option for selected cases of intramural hematoma not evident on angiography.

Keywords:
CTIVUSPCIintramural hematoma.

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