Related Experiment Video

Updated: Aug 12, 2025

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

15.9K

Chest Pain and the Dynamic Evolution of Spontaneous Coronary Artery Hematoma

Marco Franzino1, Francesco Costa1, Tommaso De Ferrari1

  • 1Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, AOU Policlinic "G. Martino," Messina, Italy.

JACC. Case Reports
|January 27, 2023
PubMed

Insights

Spontaneous coronary intramural hematoma (SCIH) is a rare cause of chest pain. This case highlights SCIH as a cause of myocardial infarction with nonobstructive coronary arteries.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Pathophysiology

Background:

  • Spontaneous coronary intramural hematoma (SCIH) is an uncommon cardiovascular condition.
  • SCIH can present with acute chest pain, mimicking other cardiac emergencies.
  • Early diagnosis is crucial for appropriate management.

Observation:

  • A patient presented with acute chest pain and was diagnosed with myocardial infarction.
  • Initial coronary angiography showed nonobstructive coronary arteries.
  • Cardiac magnetic resonance imaging (CMR) indicated an ischemic pattern.

Findings:

  • Subsequent angiography revealed coronary artery occlusion.
  • The occlusion was attributed to spontaneous coronary intramural hematoma (SCIH).
  • SCIH demonstrated dynamic evolution in this case.

Implications:

  • This case underscores the importance of considering SCIH in patients with myocardial infarction and nonobstructive coronary arteries.
  • Advanced imaging like CMR can aid in diagnosing SCIH.
  • Recognizing SCIH is vital for accurate diagnosis and treatment of acute coronary syndromes.

Keywords:
CMR, cardiac magnetic resonanceCT, computed tomographyIVUSIVUS, intravascular ultrasoundMI, myocardial infarctionMINOCAMINOCA, myocardial infarction with nonobstructive coronary arteriesSCADSCAD, spontaneous coronary artery diseaseSCIH, spontaneous coronary intramural hematomaacute coronary syndromecardiac magnetic resonancespontaneous coronary intramural hematoma

More Related Videos

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.3K
Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

Published on: February 3, 2021

3.7K

Related Concept Videos

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
32
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
20
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
51
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
19
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
24
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
18